WELLSTAR MEDICAL GROUP, LLC (NPI# 1043619489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043619489 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Other Organization Name | WELLSTAR CHIROPRACTIC |
| Practice Address |
3747 Roswell Rd Ne Suite 311 Marietta GA 30062-6227 |
| Practice Telephone | 7704222326 |
| Practice Fax Number | 7704227797 |
| Mailing Telephone | 7704222326 |
| Mailing Fax Number | 7704227797 |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2015-06-08 |
| Authorized Official Name | MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 4706440095 |
| Is Organization Subpart | Y |
| Parent Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | GA | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| WellStar Chiropractic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356736250 | Wellstar Medical Group, LLC | Pediatrics | 736 Whitlock Ave Nw, Suite 600, Marietta, GA 30064-0001 | 2015-03-30 |
| 1326333907 | Wellstar Medical Group, LLC | Surgery | 4550 Cobb Parkway Nw, Suite 309-b, Acworth, GA 30101-4180 | 2011-06-13 |
| 1255633004 | Wellstar Medical Group, LLC | Family Medicine | 3747 Roswell Rd Ne, Suite 216, Marietta, GA 30062-6234 | 2010-11-30 |
| 1639533896 | Wellstar Medical Group, LLC | Surgery | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2016-04-13 |
| 1275992240 | Wellstar Medical Group, LLC | Clinic/Center | 805 Sandy Plains Rd, Marietta, GA 30066-6340 | 2016-02-18 |
| 1821466509 | Wellstar Medical Group, LLC | Internal Medicine | 1605 Mulkey Rd, Suite 220, Austell, GA 30106-1127 | 2015-09-11 |
| 1346624160 | Wellstar Medical Group, LLC | Internal Medicine | 1605 Mulkey Rd, Suite 220, Austell, GA 30106-1127 | 2015-07-10 |
| 1588059653 | Wellstar Medical Group, LLC | Family Medicine | 12 Medical Dr Ne, Cartersville, GA 30121-8002 | 2015-04-05 |
| 1720471931 | Wellstar Medical Group, LLC | Pediatrics | 677 Church St Ne, Suite 100 P, Marietta, GA 30060-1101 | 2015-03-12 |
| 1811380025 | Wellstar Medical Group, LLC | Psychiatry & Neurology | 780 Canton Rd Ne, Suite 400, Marietta, GA 30060-7298 | 2015-03-12 |
| Street Address |
3747 ROSWELL RD NE SUITE 311 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-6227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255633004 | Wellstar Medical Group, LLC | Family Medicine | 3747 Roswell Rd Ne, Suite 216, Marietta, GA 30062-6234 | 2010-11-30 |
| 1972907293 | Wellstar Medical Group, LLC | Anesthesiology | 3747 Roswell Rd Ne, Suite 311, Marietta, GA 30062-6227 | 2014-10-15 |
| 1669752911 | Wellstar Medical Group, LLC | Internal Medicine | 3747 Roswell Rd Ne, Suite 212, Marietta, GA 30062-6215 | 2011-08-18 |
| 1407141088 | Wellstar Medical Group, LLC | Pediatrics | 3747 Roswell Rd Ne, Suite 201, Marietta, GA 30062-6215 | 2011-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245249 | Aaron D Young | Chiropractor | 860 Baltimore Pl Sw, Marietta, GA 30064-3959 | 2020-11-05 |
| 1831790435 | Li Ma | Chiropractor | 376 Powder Springs St Ste 141, Marietta, GA 30064-3460 | 2020-11-02 |
| 1558977397 | Kristin Best | Chiropractor | 1189 Ashborough Dr Se Apt A, Marietta, GA 30067-6918 | 2020-09-17 |
| 1528677499 | Milan Modi | Chiropractor | 3225 Shallowford Rd Ste 700, Marietta, GA 30062-7026 | 2020-07-27 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1578199113 | Munntouya Hunt | Chiropractor | 2185 Palmyra Dr Se, Marietta, GA 30067-6681 | 2020-03-16 |
| 1851926083 | Nicholas Weston | Chiropractor | 2560 Delk Rd Se, Marietta, GA 30067-6323 | 2020-03-09 |
| 1003447418 | Nathan Bennett | Chiropractor | 3901 Mary Eliza Trce Nw Ste 201, Marietta, GA 30064-1096 | 2020-02-04 |
| 1285274480 | Cory Plasker | Chiropractor | 519b Johnson Ferry Road, Suite 350, Marietta, GA 30068 | 2020-01-15 |
| 1770129587 | Tuyet Thy Dang | Chiropractor | 2609 Deerfield Cir Sw, Marietta, GA 30064-4205 | 2019-11-27 |
| Find all providers in MARIETTA | ||||
Please comment or provide details below to improve the information on WELLSTAR MEDICAL GROUP, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.