NPIMap

Organization Active NPI

Wellstar Health System, Inc

Doing business as WellStar Homecare Services - Private Homecare

  • Nursing Care Agency
  • Marietta, GA
National Provider Identifier
1821076001
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
003-R-0043 Issued in GA
Legal business name
WELLSTAR HEALTH SYSTEM, INC
Doing business as
WellStar Homecare Services - Private Homecare
Practice address
805 Sandy Plains Rd
Marietta, GA 30066-6340
Phone
(770) 792-1616
Fax
(770) 792-1687
NPI assigned
Jan 6, 2006
Last updated
Feb 24, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
WELLSTAR HOMECARE SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Authorized official

Name
Anthony J Budzinski
Title
Evp
Phone
(470) 644-0012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 003-R-0043 GA Primary

Addresses

Primary practice location

805 Sandy Plains Rd
Marietta, GA 30066-6340

Mailing address

1800 Parkway PL SE Ste 500
Marietta, GA 30067-8237
Phone (470) 956-4981

Other identifiers 3

IdentifierTypeStateIssuer
00904593BMedicaidGA
00862694AMedicaidGA
00862694BMedicaidGA

Other names 1

  • WellStar Homecare Services - Private Homecare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wellstar Behavioral Hea5 organizations share this tax ID, including this one
Part of
Wellstar Homecare Billing LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1821076001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 PARKWAY PL SE STE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678237",
            "telephone_number": "470-956-4981",
            "fax_number": "770-999-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 SANDY PLAINS RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666340",
            "telephone_number": "770-792-1616",
            "fax_number": "770-792-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR HEALTH SYSTEM, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTAR HOMECARE SERVICES",
        "enumeration_date": "2006-01-06",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "BUDZINSKI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "470-644-0012"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "003-R-0043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00904593B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00862694A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00862694B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellStar Homecare Services - Private Homecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellStar Homecare Services - Private Homecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 24, 2020; 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.