WELLSTAR POWDER SPRINGS MEDICAL CENTER - NPI 1093011603 - Family Medicine in Powder Springs, GA

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

The NPI number for Wellstar Medical Group, LLC is 1093011603. It was assigned to this organization in the NPPES registry on January 28, 2011. The provider is doing business as Wellstar Powder Springs Medical Center.

Q: What is Wellstar Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About Wellstar Powder Springs Medical Center NPPES

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

WELLSTAR POWDER SPRINGS MEDICAL CENTER (NPI 1093011603) is a healthcare organization registered as a family medicine in Powder Springs, Georgia and active in the NPI registry since January 2011. The organization holds a CLIA Waiver certificate valid through June 18, 2027 and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1093011603

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameWELLSTAR MEDICAL GROUP, LLC

Location Address4250 BROWNSVILLE RDPowder Springs, GA 30127-2559

Mailing Address4250 Brownsville RdPowder Springs, GA 30127-2559 · (678) 567-8000 · Fax (770) 439-3555

Phone(678) 567-8000

Fax(770) 439-3555

Organization SubpartYes

Authorized OfficialNicole AsheExecutive Director Of Finance · (470) 644-0095

Enumeration DateJanuary 28, 2011

Last NPPES UpdateNovember 19, 2013

✔ NPI 1093011603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4250 BROWNSVILLE RD, Powder Springs, GA 30127

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Other Names 1

Doing Business AsWellstar Powder Springs Medical Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 of Waiver 11D0906124

Wellstar Powder Springs Medical Center · Powder Springs, GA

Active · expires Jun 18, 2027

CLIA Number11D0906124

Laboratory TypePhysician Office

Certificate Effective DateJune 19, 2025

Certificate Expiration DateJune 18, 2027

Laboratory DirectorMichael Christa

Laboratory Phone(678) 567-8000

Laboratory LocationWellstar Powder Springs Medical Center4250 Brownsville Rd, Powder Springs, GA 30127

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

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

DR. MICHAEL W CHRISTA MD

Family Medicine