Wellstar Clinical Partners Medicare Aco, LLC

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

WELLSTAR CLINICAL PARTNERS MEDICARE ACO, LLC

Doing business as

WellStar ACO

Practice address

793 Sawyer Rd
Marietta, GA 30062-2222

Phone

(470) 644-0012

Fax

(770) 563-0730

NPI assigned

Apr 2, 2012

Organization subpart

Yes

Parent organization

WELLSTAR CLINICAL PARTNERS MEDICARE ACO, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Jim Budzinski

Title

Exec. VP & Chief Financial Officer

Phone

(470) 644-0012

Specialties & licenses 1

Addresses

Other names 1

• WellStar ACO Doing business as

Part of

Wellstar Clinical Partners Medicare Aco LLC

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1982970190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 SAWYER RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622222",
            "telephone_number": "470-644-0012",
            "fax_number": "770-563-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 SAWYER RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622222",
            "telephone_number": "470-644-0012",
            "fax_number": "770-563-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR CLINICAL PARTNERS MEDICARE ACO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTAR CLINICAL PARTNERS MEDICARE ACO, LLC",
        "enumeration_date": "2012-04-02",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "BUDZINSKI",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "EXEC. VP & CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "470-644-0012",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellStar ACO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellStar ACO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Voluntary or Charitable Agency in Marietta, GA
• Providers in Marietta, GA by specialty
• Voluntary or Charitable Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.