Family Wellcare Center Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAMILY WELLCARE CENTER INC.

Practice address

3823 Roswell Rd
Suite 214
Marietta, GA 30062-6278

Phone

(678) 886-4602

NPI assigned

Oct 1, 2008

Last updated

Oct 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Luis M Medina

Title

President

Phone

(678) 886-4602

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1922259563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3823 ROSWELL RD",
            "address_2": "SUITE 214",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626278",
            "telephone_number": "678-886-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3823 ROSWELL RD",
            "address_2": "SUITE 214",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626278",
            "telephone_number": "678-886-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY WELLCARE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-886-4602"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.