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WELLSTAR EAST PAULDING PRIMARY CARE CENTER
NPI 1003112640
Internal Medicine in Hiram, GA

Active since January 30, 2011CLIA Certified · 2 labs
176 CHARLES HARDY PKWY, UNIT C, HIRAM, GA 30141(678) 945-8200(678) 945-8209 Get Directions Write a Review

NPPES record last updated: November 19, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wellstar East Paulding Primary Care Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WELLSTAR EAST PAULDING PRIMARY CARE CENTER (NPI 1003112640) is a healthcare organization registered as an internal medicine in Hiram, Georgia and active in the NPI registry since January 2011. The organization holds 2 active CLIA laboratory certificates and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1003112640
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameWELLSTAR MEDICAL GROUP, LLC
Location Address176 CHARLES HARDY PKWY, UNIT CHiram, GA 30141-1836
Mailing Address176 Charles Hardy Pkwy, Unit CHiram, GA 30141-1836 · (678) 945-8200 · Fax (678) 945-8209
Phone(678) 945-8200
Fax(678) 945-8209
Organization SubpartYes
Authorized OfficialNicole AsheExecutive Director Of Finance · (470) 644-0095
Enumeration DateJanuary 30, 2011
Last NPPES UpdateNovember 19, 2013
✔ NPI 1003112640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
176 CHARLES HARDY PKWY, Hiram, GA 30141
Open in Google Maps ↗

Other Names 1

Doing Business AsWellstar East Paulding Primary Care Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D2136946

Wellstar Medical Group Urogynecology At Paulding · Hiram, GA
Active · expires Sep 18, 2027
CLIA Number11D2136946
Laboratory TypePhysician Office
Certificate Effective DateSeptember 19, 2025
Certificate Expiration DateSeptember 18, 2027
Laboratory DirectorDeborah Karp
Laboratory Phone(470) 956-4050
Laboratory LocationWellstar Medical Group Urogynecology At Paulding148 Bill Carruth Parkway, Suite 260, Hiram, GA 30141
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 11D2089724

Wellstar Medical Group Ent- Hiram · Hiram, GA
Active · expires Jan 6, 2027
CLIA Number11D2089724
Laboratory TypePhysician Office
Certificate Effective DateJanuary 7, 2025
Certificate Expiration DateJanuary 6, 2027
Laboratory DirectorMichael Vick
Laboratory Phone(770) 505-0023
Laboratory LocationWellstar Medical Group Ent- Hiram148 Bill Carruth Pkwy Suite 220, Hiram, GA 30141
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CARL GOOLSBY JR. MD
Family Medicine
176 CHARLES HARDY PKWY, UNIT C
HIRAM, GA 30141
Paulding County (678) 945-8200
AFUA AKHI-GBADE M.D.
Family Medicine
176 CHARLES HARDY PKWY
HIRAM, GA 30141
Paulding County (678) 945-8200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wellstar Medical Group, LLC's NPI number?

The NPI number for Wellstar Medical Group, LLC is 1003112640. It was assigned to this organization in the NPPES registry on January 30, 2011. The provider is doing business as Wellstar East Paulding Primary Care Center.

Where is Wellstar Medical Group, LLC located?

Wellstar Medical Group, LLC is located at 176 Charles Hardy Pkwy Unit C, Hiram, GA 30141. The listed phone number is (678) 945-8200.

What is Wellstar Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Wellstar Medical Group, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Wellstar Medical Group, LLC was last updated on November 19, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.