Active NPI
Joseph W Redcross II, D.O.
- Surgery Physician
- Marietta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 69941
- Practice address
- 55 Whitcher St NE Ste 130
Marietta, GA 30060-1156 - Phone
- (770) 428-0462
- Fax
- (770) 427-8001
- NPI assigned
- Jul 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 1132 | SC | |
| Surgery Physician | 208600000X | OT 010413 | PA | |
| Surgery Physician | 208600000X | 69941 | GA | Primary |
| Phlebology Physician | 202K00000X | 1132 | SC |
Addresses
Primary practice location
55 Whitcher St NE Ste 130
Marietta, GA 30060-1156
Mailing address
55 Whitcher St NE Ste 130
Marietta, GA 30060-1156
Phone (770) 428-0462
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP3518 | Medicaid | SC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jredcross55659@directwellstar.org |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69941 | GA | MD | Surgery Physician |
| OT 010413 | PA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| The Southeast Permanente Medical Group | Surgery | Current | Accepting new patients |
| Wellstar Medical Group, LLC | Current | Accepting new patients |
Locations
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000
2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3649
5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
55 Whitcher St NE
Ste 130
Marietta, GA 30060
Phone (770) 426-1629
1125 Town Center Village Dr
McDonough, GA 30253
Phone (678) 583-6557
20 Glenlake Pkwy
Sandy Springs, GA 30328
Phone (770) 677-6247
5665 Ptree Dunwoody Rd NE
Sandy Springs, GA 30342
Phone (678) 843-7001
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1245266956
Surgery
-
dba WellStar Family Medicine ACW
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573171200000",
"number": "1912107640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WHITCHER ST NE STE 130",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601156",
"telephone_number": "770-428-0462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 WHITCHER ST NE STE 130",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601156",
"telephone_number": "770-428-0462",
"fax_number": "770-427-8001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDCROSS",
"first_name": "JOSEPH",
"middle_name": "W",
"name_suffix": "II",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-20",
"last_updated": "2019-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "1132",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "OT 010413",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "69941",
"primary": true
},
{
"code": "202K00000X",
"taxonomy_group": "",
"desc": "Phlebology",
"state": "SC",
"license": "1132",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP3518",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jredcross55659@directwellstar.org",
"affiliation": "N",
"address_1": "55 Whitcher St NE Ste 130",
"city": "Marietta",
"state": "GA",
"country_code": "US",
"postal_code": "300601156",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.