WELLSTAR MEDICAL GROUP, LLC (NPI# 1669752911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669752911 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Other Organization Name | WELLSTAR ENDOCRINOLOGY |
| Practice Address |
3747 Roswell Rd Ne Suite 212 Marietta GA 30062-6215 |
| Practice Telephone | 6784034300 |
| Practice Fax Number | 7709992166 |
| Mailing Telephone | 6784034300 |
| Mailing Fax Number | 7709992166 |
| Enumeration Date | 2011-08-18 |
| 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 | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WellStar Endocrinology | 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 212 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-6215 |
| 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 |
| 1043619489 | Wellstar Medical Group, LLC | Chiropractor | 3747 Roswell Rd Ne, Suite 311, Marietta, GA 30062-6227 | 2014-08-21 |
| 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 | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043288418 | Lloyd Damon Weddington | Internal Medicine | 3747 Roswell Rd Ste 216, Marietta, GA 30062-6227 | 2006-03-10 |
| 1295715027 | Elyse Wendy Glaser | Internal Medicine | 3633 Blake Ford Club Drive, Marietta, GA 30062 | 2006-01-18 |
| 1730179060 | Jean E Molinary | Internal Medicine | 625 Church Street Nw, Marietta, GA 30060-1155 | 2005-10-27 |
| 1295730638 | Jane Alano Cases | Internal Medicine | 701 Hildreth Ln, Marietta, OH 45750-1768 | 2005-06-14 |
| 1366681751 | Sadeka Shahani | Internal Medicine | 625 Church St Ne, Marietta, GA 30060-1101 | 2009-02-09 |
| 1700958394 | Sona P Amin | Internal Medicine | 3939 Roswell Rd, Suite 110, Marietta, GA 30062-6251 | 2006-11-15 |
| 1982650511 | Nitin N. Mayur, Md D/b/a Wellstar Medical Specialists | Internal Medicine | 55 Whitcher St Ne, Suite 400, Marietta, GA 30060-1155 | 2006-05-25 |
| 1912997255 | Sharvari N Rangnekar | Internal Medicine | 625 Church Street Nw, Marietta, GA 30060-1155 | 2005-10-27 |
| 1265422505 | Seymour J Rosenbloom | Internal Medicine | 625 Church Street Nw, Marietta, GA 30060-1155 | 2005-10-27 |
| 1669462990 | Nitin N Mayur | Internal Medicine | 625 Church Street Nw, Marietta, GA 30060-1155 | 2005-10-27 |
| Find all providers in MARIETTA | ||||
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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.