WELLSTAR MEDICAL GROUP, LLC (NPI# 1972907293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972907293 |
| Entity Type | Organization |
| Organization Name | WELLSTAR MEDICAL GROUP, LLC |
| Other Organization Name | WELLSTAR PAIN MEDICINE |
| Practice Address |
3747 Roswell Rd Ne Suite 311 Marietta GA 30062-6227 |
| Practice Telephone | 7704222326 |
| Practice Fax Number | 7704227797 |
| Mailing Telephone | 7704222326 |
| Mailing Fax Number | 7704227797 |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2015-07-09 |
| 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 | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WellStar Pain Medicine | 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 311 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-6227 |
| 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 |
| 1043619489 | Wellstar Medical Group, LLC | Chiropractor | 3747 Roswell Rd Ne, Suite 311, Marietta, GA 30062-6227 | 2014-08-21 |
| 1669752911 | Wellstar Medical Group, LLC | Internal Medicine | 3747 Roswell Rd Ne, Suite 212, Marietta, GA 30062-6215 | 2011-08-18 |
| 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 | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376808154 | Total Quality Management Professional Corporation Services | Anesthesiology | 2483 Powder Springs Rd Sw Ste B, Marietta, GA 30064-4573 | 2012-07-09 |
| 1780971994 | Ankur Bharat Patel | Anesthesiology | 790 Church St Ne Ste 550, Marietta, GA 30060 | 2011-07-08 |
| 1023127875 | Donald R Taylor | Anesthesiology | 840 Church Street, Suite B, Marietta, GA 30060 | 2006-08-29 |
| 1912948944 | Howard Jones Williams IIi | Anesthesiology | 2520 Windy Hill Road, Suite 204, Marietta, GA 30067-8650 | 2006-06-09 |
| 1114962156 | John G Porter | Anesthesiology | 790 Church St Ne, Suite 550, Marietta, GA 30060-7282 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093331423 | Premier Healthcare Center Corp | Anesthesiology | 4153 Flat Shoals Pkwy Ste 102, Decatur, GA 30034-4106 | 2020-06-22 |
| 1205457710 | Urgent Pain Management, Inc | Anesthesiology | 1001 Virginia Ave, Hapeville, GA 30354-1328 | 2020-05-06 |
| 1831710854 | Md Pain Care, P.C. | Anesthesiology | 333 Alcovy St Ste 3, Monroe, GA 30655-2180 | 2020-04-30 |
| 1295356210 | Md Pain Care, P.C. | Anesthesiology | 5109 Highway 278 Ne Ste C, Covington, GA 30014-2608 | 2020-04-30 |
| 1407475296 | Georgia Injury & Pain Specialists | Anesthesiology | 7001 Hodgson Memorial Dr Ste 5, Savannah, GA 31406-2549 | 2020-04-11 |
| 1023645629 | Nexus Pain Center of Lagrange LLC | Anesthesiology | 1075 Lafayette Pkwy Ste 230, Lagrange, GA 30241-3734 | 2020-03-24 |
| 1255820502 | Georgia Pain and Spine Solutions, PC | Anesthesiology | 76 Highland Pavilion Court, #133, Hiram, GA 30141-3170 | 2018-05-02 |
| 1336527191 | Palmetto Pain Management of Ga, LLC | Anesthesiology | 5745 Clarion St, Cumming, GA 30040-0305 | 2015-05-13 |
| 1033546999 | Pain Management Specialists of Atlanta P C | Anesthesiology | 616a S 8th St, Suite A, Griffin, GA 30224-4214 | 2013-10-08 |
| 1649615584 | Nj Medical Services PC | Anesthesiology | 1016 Thompson Bridge Rd, Gainesville, GA 30501-1704 | 2013-05-06 |
| 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.