NPIMap

Organization Active NPI

Wellstar Douglasville Medical Center, LLC

  • Internal Medicine Physician
  • Douglasville, GA
National Provider Identifier
1992751564
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 DOUGLASVILLE MEDICAL CENTER, LLC
Practice address
8820 Hospital Dr
Douglasville, GA 30134-2266
Phone
(770) 947-3000
Fax
(770) 947-3012
NPI assigned
May 25, 2006
Last updated
Jul 14, 2008By the provider in NPPES
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) 947-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

8820 Hospital Dr
Douglasville, GA 30134-2266

Mailing address

8820 Hospital Dr
Douglasville, GA 30134-2266
Phone (770) 947-3000

National Provider Directory

National Provider Directory
Part of
Wellstar Behavioral Hea

Locations

8820 Hospital Dr
Douglasville, GA 30134
Phone (678) 480-4034

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1992751564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8820 HOSPITAL DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342266",
            "telephone_number": "770-947-3000",
            "fax_number": "770-947-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 HOSPITAL DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342266",
            "telephone_number": "770-947-3000",
            "fax_number": "770-947-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR DOUGLASVILLE MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTAR HEALTH SYSTEM, INC.",
        "enumeration_date": "2006-05-25",
        "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": "770-947-3000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, 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.