WELLSTAR MEDICAL GROUP, LLC (NPI# 1538467303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538467303 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Other Organization Name | WELLSTAR ALLERGY & ASTHMA |
| Practice Address |
4480 N Cooper Lake Rd Se Ste. 101 Smyrna GA 30082-4622 |
| Practice Telephone | 7703332027 |
| Practice Fax Number | 7703332031 |
| Mailing Telephone | 7703332027 |
| Mailing Fax Number | 7703332031 |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2013-11-19 |
| 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 | 207K00000X | Allergy & Immunology | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WellStar Allergy & Asthma | 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 |
4480 N COOPER LAKE RD SE STE. 101 |
| City | SMYRNA |
| State | GA |
| Zip Code | 30082-4622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205823184 | Michael D Simpson | Internal Medicine | 4480 N Cooper Lake Rd Se, Smyrna, GA 30082-4622 | 2005-10-05 |
| 1669767364 | Wellstar Medical Group, LLC | Clinic/Center | 4480 N Cooper Lake Rd Se, Suite 100, Smyrna, GA 30082-4622 | 2011-06-10 |
| 1023301033 | Wellstar Medical Group, LLC | Internal Medicine | 4480 N Cooper Lake Rd Se, Suite 201, Smyrna, GA 30082-4622 | 2011-05-24 |
| 1780985739 | Nanette Cook Md Ob-gyn PC | Clinic/Center | 4480 N Cooper Lake Rd Se, Suite 220, Smyrna, GA 30082-4622 | 2010-11-08 |
| 1528386349 | Wellstar Rheumatology, LLC | Internal Medicine | 4480 N Cooper Lake Rd Se, Suite 201, Smyrna, GA 30082-4622 | 2010-05-05 |
| 1174765853 | Elizabeth Jean Reardon | Nurse Practitioner | 4480 N Cooper Lake Rd Se, Suite 201, Smyrna, GA 30082-4622 | 2009-03-27 |
| 1205987815 | Spencer Alexander Patrick | Dentist | 4480 N Cooper Lake Rd Se, Suite 210, Smyrna, GA 30082-4621 | 2007-01-12 |
| 1295832004 | James K Smith | Internal Medicine | 4480 N Cooper Lake Rd Se, Smyrna, GA 30082 | 2006-09-20 |
| 1841245719 | Surabhi Arjunan | Internal Medicine | 4480 N Cooper Lake Rd Se, Suite 201, Smyrna, GA 30082-4622 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528600335 | Arden Constance Mobley | Occupational Therapist | 3200 Highlands Parkway Suite 150, Smyrna, GA 30082 | 2019-10-14 |
| 1386185916 | Nicholas Andrews | Behavior Technician | 5034 Laurel Bridge, Smyrna, GA 30082 | 2017-03-15 |
| 1518331362 | Shannon Wilkerson | Counselor | 3040 Highlands Pkwy, Ste G, Smyrna, GA 30082 | 2015-11-17 |
| 1235529611 | Frances Offiah Idowu | Nurse Practitioner | 3240 South Cobb Drive, Smyrna, GA 30082 | 2015-01-23 |
| 1053717850 | Deena Altman Spital | Physician Assistant | 400 Technology Ct, Suite J, Smyrna, GA 30082 | 2014-11-06 |
| 1487964193 | Revive Athletics, Inc | Counselor | 460 Bourne Drive, Smyrna, GA 30082 | 2010-10-15 |
| 1386956746 | Kalpit C Patel | Family Medicine | 4480 N Cooper Lake Rd Se Ste 100, Smyrna, GA 30082 | 2010-07-13 |
| 1285826800 | David Goziem Nwabunor | Emergency Medicine | 415 Oak Brook Ct Se, Smyrna, GA 30082 | 2007-08-16 |
| 1437357373 | Amit M Patel | Plastic Surgery | 3968 Felton Hill Rd Sw, Ste 100, Smyrna, GA 30082 | 2007-07-03 |
| 1225103849 | Daniel C Norris Dds PC | Dentist | 620 Concord Rd, Smyrna, GA 30082 | 2006-11-21 |
| Find all providers in zip 30082 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770786915 | Belinda Kaye Graham | Allergy & Immunology | 4480 N Cooper Lake Rd Se Ste 101, Smyrna, GA 30082-4623 | 2007-06-06 |
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|---|---|---|---|---|
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| 1750902185 | Center for Allergy and Asthma Southern Crescent | Allergy & Immunology | 1975 Highway 54 W Ste 255, Peachtree City, GA 30269-4794 | 2020-04-27 |
| 1003472036 | Annual Wellness Centers of America | Allergy & Immunology | 753 Old Norcross Rd Ste B, Lawrenceville, GA 30046-4312 | 2019-05-15 |
| 1821567371 | Breathe Better Allergy Asthma & Sinus Center, Inc | Allergy & Immunology | 950 S Enota Dr Ne Ste A, Gainesville, GA 30501-2439 | 2018-11-14 |
| 1982111316 | Sofia Miriam Sheikh | Allergy & Immunology | 4003 Oak Forest Dr Ne, Marietta, GA 30062-8022 | 2018-01-08 |
| 1366969560 | Allergy Consulting Group, LLC | Allergy & Immunology | 5752b Buford Hwy Ne, Doraville, GA 30340-1207 | 2017-08-28 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1730597196 | Allergy Testing Solutions, LLC | Allergy & Immunology | 789 Hammond Dr, Unit 2510, Sandy Springs, GA 30328-8161 | 2014-07-30 |
| 1164863999 | Chih-yin Yeh | Allergy & Immunology | 5673 Peachtree Dunwoody Rd # 445, Atlanta, GA 30342-1731 | 2013-07-09 |
| 1023352069 | Advanced Allergy Inc | Allergy & Immunology | 5512 Glenridge Dr Ne, Unit A, Atlanta, GA 30342-7213 | 2012-11-15 |
| Find all providers with the same taxonomy | ||||
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| 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.