Individual provider Active NPI

Eric Daniel Wellons, M.D.

  • Vascular Surgery Physician
  • Newnan, GA
National Provider Identifier
1790761799
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
049120 Issued in GA
Practice address
775 Poplar Rd
Suite 260
Newnan, GA 30265-8300
Phone
(404) 524-0095
Fax
(404) 658-9558
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 049120 GA Primary

Addresses

Primary practice location

775 Poplar Rd
Suite 260
Newnan, GA 30265-8300

Mailing address

775 Poplar Rd
Suite 260
Newnan, GA 30265-8300
Phone (404) 524-0095

Other identifiers 1

IdentifierTypeStateIssuer
00944347AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928000153 GA Practitioner - Vascular Surgery 0446392906 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Virginia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rosenthal, Clark and MatsurraGroup PAC ID 8729001938, 7 clinicians
Newnan Vascular Center, LLCGroup PAC ID 7113043167, 5 clinicians

Practice addresses (Care Compare)

1233 Hwy 54 W
Suite 210
Fayetteville, GA 30214-4542
Phone (404) 524-0095

1521 W McIntosh Rd
Griffin, GA 30223-1773
Phone (404) 524-0095

2201 Newnan Crossing Blvd
Suite 200
Newnan, GA 30265-2551
Phone (404) 524-0095

2690 Hwy 34 E
Suite a
Newnan, GA 30265-1330
Phone (678) 423-4100

Hospital & facility affiliations

  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Morgan Medical Center Hospital, Madison, GA, CCN 111304

Merit-based Incentive Payment System (MIPS)

Final score
92.18 of 100Reported as group
Quality
74.66
Promoting interoperability
99
Improvement activities
40
Cost
83.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion34
Varicose vein removal45
Leg revascularization (restoring blood flow)1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Newnan Vascular Center, LLC CurrentSince Aug 2, 2010 Accepting new patients
Morgan County Georgia Hospital Authority Current Accepting new patients
City of Hope Medical Group of Georgia LLC CurrentSince Oct 28, 2020 Accepting new patients
Rosenthal, Clark and Matsurra CurrentSince Jul 1, 2002 Accepting new patients

Locations

3001 Palm Harbor Blvd
Ste A
Palm Harbor, FL 34683

1233 Highway 54 W
Ste 210
Fayetteville, GA 30214
Phone (404) 350-0106

1521 W McIntosh Rd
Griffin, GA 30223
Phone (404) 524-0095

2201 Newnan Crossing Blvd E
Ste 200
Newnan, GA 30265
Phone (404) 524-0095

2690 Highway 34 E
Ste A
Newnan, GA 30265
Phone (678) 423-4100

775 Poplar Rd
Ste 350
Newnan, GA 30265
Phone (470) 419-4380

775 Poplar Rd
Ste 260
Newnan, GA 30265
Phone (404) 524-0095

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

2690 Highway 34 E
Ste B
Newnan, GA 30265
Phone (404) 524-0095

62742 Collections Ctr Dr
Chicago, IL 60693

Interoperability endpoints

  • Direct secure messaging: ericwellons@mmc.medalliesdirect.net
  • Direct secure messaging: ewellons145312@cityofhope.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1790761799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 POPLAR RD",
            "address_2": "SUITE 260",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658300",
            "telephone_number": "404-524-0095",
            "fax_number": "404-658-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 POPLAR RD",
            "address_2": "SUITE 260",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658300",
            "telephone_number": "404-524-0095",
            "fax_number": "404-658-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLONS",
        "first_name": "ERIC",
        "middle_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "049120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00944347A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.