WELLSTAR CLINICAL PARTNERS MEDICARE ACO, LLC (NPI# 1982970190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982970190 |
| Entity Type | Organization |
| Organization Name | WELLSTAR CLINICAL PARTNERS MEDICARE ACO, LLC |
| Other Organization Name | WELLSTAR ACO |
| Practice Address |
793 Sawyer Rd Marietta GA 30062-2222 |
| Practice Telephone | 4706440012 |
| Practice Fax Number | 7705630730 |
| Mailing Telephone | 4706440012 |
| Mailing Fax Number | 7705630730 |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2019-05-20 |
| Authorized Official Name | MR. JIM BUDZINSKI (EXEC. VP & CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4706440012 |
| Is Organization Subpart | Y |
| Parent Organization Name | WELLSTAR CLINICAL PARTNERS MEDICARE ACO, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251V00000X | Voluntary or Charitable | GA | Agencies |
| Other Name | Type Code |
|---|---|
| WellStar ACO | Doing Business As Name - Organization |
| Street Address |
793 SAWYER RD |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-2222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275068173 | Ebanga Agbor | Nurse Practitioner | 793 Sawyer Rd, Marietta, GA 30062-2222 | 2017-04-28 |
| 1134501422 | Wellstar Health System, LLC | Clinic/Center | 793 Sawyer Rd, Marietta, GA 30062-2222 | 2015-06-23 |
| 1215330451 | Wellstar Medical Group, LLC | Transplant Surgery | 793 Sawyer Rd, Marietta, GA 30062-2222 | 2014-10-02 |
| 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 | 251V00000X |
| Grouping | Agencies |
| Classification | Voluntary or Charitable |
| Definition to come... |
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| 1568431518 | Eve, Incorporated | Voluntary or Charitable | 304 6th St, Marietta, OH 45750-3245 | 2006-03-14 |
| 1881923126 | Good Samaritan Health Center of Cobb | Voluntary or Charitable | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2009-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467073239 | All About Capelli Ltd | Voluntary or Charitable | 750 Six Flags Rd Lot 358, Austell, GA 30168-7827 | 2020-05-02 |
| 1225579030 | Ace Educationinternational Inc | Voluntary or Charitable | 483 Walker Drive, Mcdonough, GA 30253 | 2017-03-13 |
| 1093253932 | Amanda Harding | Voluntary or Charitable | 8333 Office Park Drive, E, Douglasville, GA 30180-6937 | 2017-02-10 |
| 1801339692 | Nurture Future Youth Inc | Voluntary or Charitable | 185 Carolina Ln, Lavonia, GA 30553-1630 | 2016-11-28 |
| 1174987879 | Ser Familia, Inc. | Voluntary or Charitable | 1700 Water Pl Se, Atlanta, GA 30339-2006 | 2016-04-08 |
| 1649635053 | The Soulstice Center Inc | Voluntary or Charitable | 59 Central Park Dr, None, Atlanta, GA 30354-4132 | 2015-12-30 |
| 1487025482 | American Association of Integrative & Pastoral Medicine | Voluntary or Charitable | 3695 Cascade Rd Sw # 117f, Atlanta, GA 30331-2173 | 2015-10-15 |
| 1326418724 | Project Hope for Families Inc | Voluntary or Charitable | 390 Perry Hwy, Hawkinsville, GA 31036-6742 | 2015-09-29 |
| 1740650084 | The Foundation for Therapeutic and Spiritual Empowerment Svcs Inc | Voluntary or Charitable | 1246 Concord Rd Se # C, Suite 203, Smyrna, GA 30080-4394 | 2015-09-29 |
| 1114314630 | God Sent Transitional Housing | Voluntary or Charitable | 1164 Interlaken Pass, Jonesboro, GA 30238-8019 | 2015-04-22 |
| 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.