WELLSTAR MEDICAL GROUP, LLC (NPI# 1669767364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669767364 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Other Organization Name | WELLSTAR URGENT CARE AT COOPER LAKE |
| Practice Address |
4480 N Cooper Lake Rd Se Suite 100 Smyrna GA 30082-4622 |
| Practice Telephone | 7703331300 |
| Practice Fax Number | 7704328312 |
| Mailing Telephone | 7703331300 |
| Mailing Fax Number | 7704328312 |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2011-06-10 |
| Authorized Official Name | MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 7707925261 |
| Is Organization Subpart | Y |
| Parent Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| WellStar Urgent Care at Cooper Lake | 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 SUITE 100 |
| 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 |
| 1023301033 | Wellstar Medical Group, LLC | Internal Medicine | 4480 N Cooper Lake Rd Se, Suite 201, Smyrna, GA 30082-4622 | 2011-05-24 |
| 1538467303 | Wellstar Medical Group, LLC | Allergy & Immunology | 4480 N Cooper Lake Rd Se, Ste. 101, Smyrna, GA 30082-4622 | 2011-03-03 |
| 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 | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558864777 | Eden Hill Expresscare, LLC | Clinic/Center | 300 Jimmy Dr Ste 100, Smyrna, DE 19977-5804 | 2018-03-14 |
| 1235366345 | Urgent Care Xpress, LLC | Clinic/Center | 3330 South Cobb Drive, Ste: B, Smyrna, GA 30080 | 2009-06-16 |
| 1710977715 | Tennessee Urgent Care Associates, LLC | Clinic/Center | 1332 Hazelwood Dr, Smyrna, TN 37167-3922 | 2005-10-21 |
| 1205111010 | Christiana Care Health Services Inc | Clinic/Center | 100 S Main St, Smyrna Health & Wellness Center, Suite 100, Smyrna, DE 19977-1477 | 2011-10-13 |
| 1013095249 | Christiana Care Health Initiatives | Clinic/Center | 100 Main Street, Suite 101, Smyrna, DE 19977-1433 | 2006-11-02 |
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|---|---|---|---|---|
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| 1982214888 | Emergent Testing LLC | Clinic/Center | 2566 Shallowford Rd Ne Ste 204, Atlanta, GA 30345-1249 | 2020-08-05 |
| 1154931541 | The Urgent Care Center of Richmond Hill, LLC | Clinic/Center | 818 Abercorn St, Savannah, GA 31401-5933 | 2020-07-31 |
| 1346858255 | Castellum Medical Consultants LLC | Clinic/Center | 1618 Mars Hill Rd Ste A, Watkinsville, GA 30677-4847 | 2020-07-16 |
| 1861010423 | Rural Urgent Care LLC | Clinic/Center | 440 Us Highway 84 E, Cairo, GA 39828-1647 | 2020-07-10 |
| 1013535657 | Statesboro Medical Group, LLC | Clinic/Center | 1176 Brampton Ave, Statesboro, GA 30458-0847 | 2020-07-09 |
| 1083249114 | Medlife Urgent Care LLC | Clinic/Center | 345 Huntington Place Ct Ste 200, Mcdonough, GA 30253-8651 | 2020-03-09 |
| 1376173906 | Rural Urgent Care LLC | Clinic/Center | 1408 Tallahassee Hwy Ste Z, Bainbridge, GA 39819-7791 | 2020-01-23 |
| 1942846100 | Pickens Urgent Care LLC | Clinic/Center | 744 Noah Dr Ste 108-109, Jasper, GA 30143-8705 | 2019-11-22 |
| 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.