Wellstar Medical Group, Llc | |
1800 Parkway Pl Se Marietta GA 30067-8200 | |
(470) 267-2433 | |
Not Available |
Full Name | Wellstar Medical Group, Llc |
---|---|
Speciality | Clinic/Center |
Location | 1800 Parkway Pl Se, Marietta, Georgia |
Authorized Official Name and Position | Maxwell Kagan (VP/CFO) |
Authorized Official Contact | 4706440065 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Wellstar Medical Group, Llc Po Box 742322 Atlanta GA 30374-2322 Ph: () - | Wellstar Medical Group, Llc 1800 Parkway Pl Se Marietta GA 30067-8200 Ph: (470) 267-2433 |
NPI Number | 1275992240 |
---|---|
Provider Enumeration Date | 02/18/2016 |
Last Update Date | 10/31/2024 |
Medicare PECOS PAC ID | 6709065402 |
---|---|
Medicare Enrollment ID | O20230821000129 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275992240 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (Georgia) | Primary |
Provider Name | George Sich |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1093804817 PECOS PAC ID: 5597745554 Enrollment ID: I20040721001214 |
Provider Name | David J Terris |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1689683765 PECOS PAC ID: 5193710564 Enrollment ID: I20070306000453 |
Provider Name | Michelle Maxwell Lyon |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1164476479 PECOS PAC ID: 8729175187 Enrollment ID: I20080919000167 |
Provider Name | Charlton Judson Pickett |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1366429854 PECOS PAC ID: 1951466051 Enrollment ID: I20090224000144 |
Provider Name | Lane D Ulrich |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1730191081 PECOS PAC ID: 1850456344 Enrollment ID: I20111031000018 |
Provider Name | Darlene Orcutt Batastini |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538435086 PECOS PAC ID: 9638334667 Enrollment ID: I20120626000101 |
Provider Name | William Vaughn Mccall |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1902881485 PECOS PAC ID: 6901931807 Enrollment ID: I20140224001744 |
Provider Name | Peter B Rosenquist |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1033193099 PECOS PAC ID: 6204826001 Enrollment ID: I20140313002065 |
Provider Name | Imran Yaseen Gani |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1427336742 PECOS PAC ID: 8426355595 Enrollment ID: I20191008003595 |
Provider Name | Kathryn Potter |
---|---|
Provider Type | Practitioner - Dermatology |
Provider Identifiers | NPI Number: 1154740793 PECOS PAC ID: 9931327525 Enrollment ID: I20200210001558 |
Provider Name | Sean Javaheri |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1982677605 PECOS PAC ID: 9830313410 Enrollment ID: I20200415000286 |
Provider Name | Kendall Liner Buchanan |
---|---|
Provider Type | Practitioner - Dermatology |
Provider Identifiers | NPI Number: 1811359334 PECOS PAC ID: 5395080501 Enrollment ID: I20200629003549 |
Provider Name | Cory A Bryan |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1821437757 PECOS PAC ID: 0345483020 Enrollment ID: I20200727000339 |
Provider Name | Matthew Belcher |
---|---|
Provider Type | Practitioner - Dermatology |
Provider Identifiers | NPI Number: 1134568520 PECOS PAC ID: 2264666809 Enrollment ID: I20201228000953 |
Provider Name | Martin Rutkowski |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1780950923 PECOS PAC ID: 4789976556 Enrollment ID: I20210623003588 |
Provider Name | Dan-victor Giurgiutiu |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1649434317 PECOS PAC ID: 1850552076 Enrollment ID: I20210624000256 |
Provider Name | Colin Mcleod |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1750720124 PECOS PAC ID: 5890086557 Enrollment ID: I20210625000451 |
Provider Name | Evan Hiner |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1821400441 PECOS PAC ID: 8527358548 Enrollment ID: I20210707001119 |
Provider Name | Daniel Sohinki |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992094106 PECOS PAC ID: 9739484106 Enrollment ID: I20210707002927 |
Provider Name | Pushpa Shivaram |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1306192604 PECOS PAC ID: 1658503693 Enrollment ID: I20210712002313 |
Provider Name | Benjamin Barnes |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1760866545 PECOS PAC ID: 4486948015 Enrollment ID: I20210816003907 |
Provider Name | Tyler Vines |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1730618729 PECOS PAC ID: 5395019541 Enrollment ID: I20210817000567 |
Provider Name | John Plowden |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1003814856 PECOS PAC ID: 2466534318 Enrollment ID: I20211011002486 |
Provider Name | Jennifer T Allen |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1487975702 PECOS PAC ID: 3274771134 Enrollment ID: I20211011002816 |
Provider Name | Soumia Brakta |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1164749008 PECOS PAC ID: 0446476659 Enrollment ID: I20211217001756 |
Provider Name | Michael Groves |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1215180526 PECOS PAC ID: 1759569767 Enrollment ID: I20220705001906 |
Provider Name | James Kenneth Byrd |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1720285166 PECOS PAC ID: 6608031737 Enrollment ID: I20220811000534 |
Provider Name | Scott Rahimi |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1093939118 PECOS PAC ID: 3476628710 Enrollment ID: I20220909001643 |
Provider Name | Michelle Kotti |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306883269 PECOS PAC ID: 6901990761 Enrollment ID: I20220930002318 |
Provider Name | Vatsalya Kosuru |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1922536846 PECOS PAC ID: 1052707072 Enrollment ID: I20230123000744 |
Provider Name | Ashish Kataria |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1487975926 PECOS PAC ID: 0345476214 Enrollment ID: I20230223003061 |
Provider Name | Melissa Lynn Lefebvre |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1720206550 PECOS PAC ID: 7911175823 Enrollment ID: I20240214004456 |
Provider Name | Leighton Rolston James |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1346202173 PECOS PAC ID: 8921088477 Enrollment ID: I20240423000632 |
Proactive Physicians Of Marietta, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 790 Church St Ne, Suite 220, Marietta, GA 30060 Phone: 678-753-9300 Fax: 678-753-9300 | |
Benchmark Pt Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1205 Johnson Ferry Rd Ste 130, Marietta, GA 30068 Phone: 770-565-3201 Fax: 770-565-3203 | |
Premise Health Of Georgia Medical, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 86 South Cobb Drive Mail Drop 0454, Marietta, GA 30063 Phone: 770-494-4131 Fax: 770-494-7490 | |
Clifford Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1355 Church Street Ext Ne Ste G, Marietta, GA 30060 Phone: 678-388-1355 Fax: 770-422-1416 | |
Saint Joseph's Mercy Care Services, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1407 Cobb Parkway Nw, Marietta, GA 30060 Phone: 678-843-8600 | |
Epitome Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 631 Campbell Hill St Nw Ste 200, Marietta, GA 30060 Phone: 770-727-6124 | |
Wellstar East Cobb Medical Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 Johnson Ferry Rd, Marietta, GA 30068 Phone: 770-579-7900 Fax: 770-579-7962 |