WELLSTAR MEDICAL GROUP, LLC (NPI# 1760815732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760815732 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Other Organization Name | WELLSTAR BREAST SURGERY |
| Practice Address |
4550 Cobb Parkway North Nw Acworth GA 30101-4180 |
| Practice Telephone | 7709178142 |
| Practice Fax Number | 7709668864 |
| Mailing Telephone | 7709178142 |
| Mailing Fax Number | 7709668864 |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2013-08-14 |
| Authorized Official Name | 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 | 208600000X | Surgery | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WellStar Breast Surgery | 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 |
4550 COBB PARKWAY NORTH NW |
| City | ACWORTH |
| State | GA |
| Zip Code | 30101-4180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629133103 | Osagie Osarume Okundaye | Internal Medicine | 4550 Cobb Parkway North Nw, Suite 213, Acworth, GA 30101-4180 | 2006-12-26 |
| 1467897173 | Sarah Ann Freeman | Physician Assistant | 4550 Cobb Parkway North Nw, Suite 101, Acworth, GA 30101-4180 | 2013-05-08 |
| 1003171422 | Wellstar Medical Group, LLC | Internal Medicine | 4550 Cobb Parkway North Nw, Suite 201b, Acworth, GA 30101-4180 | 2012-07-11 |
| 1336402403 | Kennestone Hospital Inc | Pharmacy | 4550 Cobb Parkway North Nw, Acworth, GA 30101-4180 | 2012-06-22 |
| 1033483458 | Bobby Joel Treadwell Jr. | Physician Assistant | 4550 Cobb Parkway North Nw, Suite 309b, Acworth, GA 30101-4180 | 2012-03-02 |
| 1942506654 | Wellstar Medical Group, LLC | Family Medicine | 4550 Cobb Parkway North Nw, Suite 201, Acworth, GA 30101-4180 | 2011-01-28 |
| 1962680991 | Daniel Judah Holtz | Surgery | 4550 Cobb Parkway North Nw, Suite #309b, Acworth, GA 30101-4180 | 2008-02-01 |
| 1689796963 | Wendy Fotopoulos | Audiologist | 4550 Cobb Parkway North Nw, Acworth, GA 30101-4180 | 2007-04-06 |
| 1225178825 | Ebon Anthony Bourne | Internal Medicine | 4550 Cobb Parkway North Nw, Suite 205, Acworth, GA 30101-4143 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952931552 | A3j Incorporated | Registered Nurse | 3905 Cobb Pkwy Nw Ste 305, Acworth, GA 30101 | 2020-01-22 |
| 1043869852 | Sharron Leigh Lipscomb | Acupuncturist | 3661 Cedarcrest Rd Ste 320, Acworth, GA 30101 | 2019-09-05 |
| 1699322933 | Cowry Home Dialysis LLC | Durable Medical Equipment & Medical Supplies | 4450 Calibre Crossings Nw, Suite # 1122, Acworth, GA 30101 | 2019-08-21 |
| 1760979595 | Sandra Jeanetta Pugh | Counselor | 118 Clubhouse Crossing, Acworth, GA 30101 | 2018-04-17 |
| 1679926950 | Cindy Hatfield Fruits | Psychologist | 4839 N. Main Street, Acworth, GA 30101 | 2016-07-21 |
| 1396192563 | Philip Young | Specialist/Technologist | 4841 Lake Park Lane, Acworth, GA 30101 | 2016-05-18 |
| 1770960619 | Karen Fuller | Marriage & Family Therapist | 2487 Cedarcrest Rd Ste 722, Acworth, GA 30101 | 2015-04-29 |
| 1366830333 | Willard Hogan IIi | Physician Assistant | 1720 Mars Hill Rd Nw Ste 8-175, Acworth, GA 30101 | 2014-12-29 |
| 1386042083 | Sebastian Diaz Fischer | Chiropractor | 2639 Hickory Grove Rd, Suit 150, Ackworth, GA 30101 | 2014-12-11 |
| 1841699337 | J Chappell Md PC | Dermatology | 4450 Calibre Crossings, Suite 1208, Acworth, GA 30101 | 2014-08-20 |
| Find all providers in zip 30101 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164715801 | Andre Gentry | Surgery | 217 Brookhaven Ct, Acworth, GA 30102-2190 | 2011-05-26 |
| 1215079736 | Carlos Alberto Escobar | Surgery | 6460 Highway 92, Ste 200, Acworth, GA 30102-2998 | 2007-02-12 |
| 1679654982 | Henry John Zielinski | Surgery | 5825 Brookstone Walk Nw, Acworth, GA 30101-8439 | 2006-10-17 |
| 1902466816 | Oasis Surgical Assistants Group Resources L.L.C. | Surgery | 1720 Mars Hill Rd Nw Ste 8-175, Acworth, GA 30101-7127 | 2019-06-13 |
| 1235454745 | Jairaj Vailoor | Surgery | 2487 Cedarcrest Rd Ste 714, Acworth, GA 30101-2730 | 2010-03-29 |
| 1831348796 | Northwest Georgia Surgical Specialists, PC | Surgery | 4450 Calibre Xing Nw, Suite 1130, Acworth, GA 30101-4103 | 2008-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043824857 | Oasis Surgical Assistants LLC | Surgery | 170 Blackberry Run Dr, Dallas, GA 30132-1174 | 2020-08-31 |
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1568087260 | Anthony George Campbell | Surgery | 1475 Laney Walker Blvd, Augusta, GA 30912-0002 | 2020-06-09 |
| 1821613431 | America Stephanie Revere | Surgery | Augusta University Medical Center 1120 15th St, Augusta, GA 30912-0001 | 2020-06-09 |
| 1124653456 | Oasis Surgical Associates LLC | Surgery | 800 Kennesaw Ave Nw Ste 130, Marietta, GA 30060-1052 | 2020-03-06 |
| 1063054237 | Stacey M Lowe | Surgery | 146 Wesleyan Way, Macon, GA 31210-4400 | 2019-10-09 |
| 1356982730 | Quinones & Sanchez LLC | Surgery | 1215 Eagles Landing Pkwy Ste 105, Stockbridge, GA 30281-5084 | 2019-10-07 |
| 1891342135 | Chakita Miesha Allen | Surgery | 24 Halyard Dr, Port Wentworth, GA 31407-9755 | 2019-08-21 |
| 1720631088 | 5am P.C. | Surgery | 475 Hansell St Se, Cairo, GA 39828-3071 | 2019-07-16 |
| 1033779152 | Kathryne Holmes | Surgery | 1120 15th St Rm Bi4076, Augusta, GA 30912-0004 | 2019-06-20 |
| Find all providers with the same taxonomy | ||||
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.