NPIMap

Organization Active NPI

Wellstar Marietta Primary Care, LLC

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1821044207
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WELLSTAR MARIETTA PRIMARY CARE, LLC
Practice address
700 Church St NE
Marietta, GA 30060-7220
Phone
(770) 420-1600
Fax
(770) 420-1612
NPI assigned
May 26, 2006
Organization subpart
Yes
Parent organization
WELLSTAR HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

700 Church St NE
Marietta, GA 30060-7220

Mailing address

700 Church St NE
Marietta, GA 30060-7220
Phone (770) 420-1600

National Provider Directory

National Provider Directory
Part of
NW Ga Nealth Systems in

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1821044207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607220",
            "telephone_number": "770-420-1600",
            "fax_number": "770-420-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607220",
            "telephone_number": "770-420-1600",
            "fax_number": "770-420-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR MARIETTA PRIMARY CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTAR HEALTH SYSTEM, INC.",
        "enumeration_date": "2006-05-26",
        "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": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

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.

Verify at the official NPI Registry.