Active NPI
Wellstar Rehab Medicine, LLC
- Physical Medicine & Rehabilitation Physician
- Marietta, GA
National Provider Identifier
1780631630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- Legal business name
- WELLSTAR REHAB MEDICINE, LLC
- Practice address
- 100 Lacy St NW
Suite 150
Marietta, GA 30060-1113 - Phone
- (770) 793-7635
- Fax
- (770) 793-7645
- NPI assigned
- May 27, 2006
- Last updated
- Jul 14, 2008
- Organization subpart
- Yes
- Parent organization
- WELLSTAR HEALTH SYSTEM, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nicole Ashe
- Title
- Executive Director of Finance
- Phone
- (770) 792-5261
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | Primary |
Addresses
Primary practice location
100 Lacy St NW
Suite 150
Marietta, GA 30060-1113
Mailing address
100 Lacy St NW
Suite 150
Marietta, GA 30060-1113
Phone (770) 793-7635
National Provider Directory
National Provider Directory- Part of
- Wellstar Health Systems
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1215993600000",
"number": "1780631630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 LACY ST NW",
"address_2": "SUITE 150",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601113",
"telephone_number": "770-793-7635",
"fax_number": "770-793-7645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 LACY ST NW",
"address_2": "SUITE 150",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601113",
"telephone_number": "770-793-7635",
"fax_number": "770-793-7645"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLSTAR REHAB MEDICINE, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WELLSTAR HEALTH SYSTEM, INC.",
"enumeration_date": "2006-05-27",
"last_updated": "2008-07-14",
"status": "A",
"authorized_official_last_name": "ASHE",
"authorized_official_first_name": "NICOLE",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
"authorized_official_telephone_number": "770-792-5261"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
- Wellstar Northwest Women's Care, LLC
- Wellstar Pediatric Professionals, LLC
- Wellstar Physicians Group Hospitalists, LLC (WellStar Physicians Group Kennestone Hospitalists, LLC)
- Wellstar Professional Services, LLC
- Wellstar Psychiatry, LLC
- Wellstar Rheumatology Associates of Marietta, LLC
- Wellstar Shallowford Medical Center, LLC
- Wellstar Surgical Associates of Marietta
- Wellstar Surgical Associates of Marietta, LLC
- Wellstar Thoracic Surgery Associates, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.