WELLSTAR MEDICAL GROUP, LLC (NPI# 1811282502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811282502 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Other Organization Name | WELLSTAR COBB HOSPITALISTS |
| Practice Address |
3950 Austell Rd Austell GA 30106-1121 |
| Practice Telephone | 7707924022 |
| Practice Fax Number | 7707324023 |
| Mailing Telephone | 7707924022 |
| Mailing Fax Number | 7707324023 |
| 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 | 208M00000X | Hospitalist | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WellStar Cobb Hospitalists | 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 |
3950 AUSTELL RD |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-1121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417951369 | Olatunde Idowu | Internal Medicine | 3950 Austell Rd, Box 22, Austell, GA 30106-1121 | 2005-06-09 |
| 1962001834 | Camille Patrice Mckenzie-brown | Nurse Practitioner | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-10-22 |
| 1508487018 | Michelle Taylor Marbury | Pharmacist | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-05-06 |
| 1477174605 | Alexandra Kamman | Physical Therapist | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-04-28 |
| 1023637923 | Lauren Davison Warren | Registered Nurse | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-04-10 |
| 1932730306 | Kerstie Kay Sims | Registered Nurse | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-02-03 |
| 1386288280 | Karen L Taylor | Pharmacist | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-11-04 |
| 1619510740 | Taurus Rafeal Womble | Nurse Practitioner | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-10-22 |
| 1699325951 | Whitney Stafford | Nurse Anesthetist, Certified Registered | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-09-18 |
| 1174177752 | Amanda Mathews Vicznesky | Physician Assistant | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205222189 | Kevin Deshaun Smith | Hospitalist | 3950 Austell Rd, Austell, GA 30106 | 2015-04-08 |
| 1578811782 | Wellstar Medical Group, LLC | Hospitalist | 3950 Austell Rd, Ob/gyn Hospitalists, Austell, GA 30106-1121 | 2012-08-17 |
| 1497913867 | Benadette Kerubo Makori-nelson | Hospitalist | 3950 Austell Rd, Box 22, Austell, GA 30106-1121 | 2008-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033770771 | Your Hospitalist Team LLC | Hospitalist | 2215 Autumn Ridge Ln, Cumming, GA 30041-1358 | 2019-06-24 |
| 1780194183 | Mobin Shah Inc | Hospitalist | 352 Langshire Dr, Mcdonough, GA 30253-8055 | 2017-10-11 |
| 1972036721 | Getnet Alemu Tioum | Hospitalist | 1267 Pounds Ln, Clarkston, GA 30021-2830 | 2017-04-08 |
| 1720531692 | Zahraa Rabeeah | Hospitalist | 390 17th St Nw Unit 5031, Atlanta, GA 30363-2015 | 2016-07-27 |
| 1245614973 | Donovan Philbrick | Hospitalist | 743 Spring Street, Office of Inpatient Medicine, Gainesville, GA 30501 | 2015-07-13 |
| 1932529732 | Munir Chaudhuri | Hospitalist | 1364 Clifton Road Ne Box M7, Atlanta, GA 30322-1029 | 2014-04-18 |
| 1982979373 | Rianot Amzat | Hospitalist | 5665 Peachtree Dunwoody # Ga, Suite 500, Atlanta, GA 30342-1701 | 2012-03-19 |
| 1780970921 | Christopher Thomas Middendorf | Hospitalist | 1400 River Place, Braselton, GA 30517 | 2011-06-27 |
| 1043528268 | Medcare Physicians of Central Georgia, LLC | Hospitalist | 1040 Founders Row, Ste A, Greensboro, GA 30642-5261 | 2010-09-22 |
| 1619293354 | Aaron D Gluth | Hospitalist | 1364 Clifton Rd Ne Box M-7, Atlanta, GA 30322-1059 | 2010-04-19 |
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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.