WELLSTAR DOUGLAS SURGICAL ASSOCIATES
NPI 1164715132
Surgery in Douglasville, GA
NPI Status: Active since May 24, 2011
Contact Information
4904 TIMBER RIDGE DR
SUITE 104
DOUGLASVILLE, GA
ZIP 30135
Phone: (770) 942-4822
Fax: (770) 942-5311
- Organization
- Surgery
- CLIA Number: 11D2328194
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-05-2027
About WELLSTAR DOUGLAS SURGICAL ASSOCIATES
This page provides the complete NPI Profile along with additional information for Wellstar Douglas Surgical Associates, a provider established in Douglasville, Georgia operating as a Surgery. The healthcare provider is registered in the NPI registry with number 1164715132 assigned on May 2011. The practitioner's primary taxonomy code is 208600000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Wellstar Douglas Surgical Associates. The authorized official of this NPI record is Mrs. Nicole Ashe (Executive Director Of Finance)
- NPI
- 1164715132
- Provider Legal Name
- WELLSTAR MEDICAL GROUP, LLC
- Other Organization Name
- WELLSTAR DOUGLAS SURGICAL ASSOCIATES
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4904 TIMBER RIDGE DR SUITE 104 DOUGLASVILLE, GA 30135
- Location Phone
- (770) 942-4822
- Location Fax
- (770) 942-5311
- Mailing Address
- 4904 TIMBER RIDGE DR SUITE 104 DOUGLASVILLE, GA 30135
- Mailing Phone
- (770) 942-4822
- Mailing Fax
- (770) 942-5311
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-24-2011
- Last Update Date
- 11-19-2013
- Code Navigator
A surgeon like Wellstar Douglas Surgical Associates treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery
- Taxonomy Code
- 208600000X
- Type
- Allopathic & Osteopathic Physicians
- License State
- GA
- Taxonomy Description
- A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2328194
- Facility Type
- Physician Office
- Certificate Effective Date
- August 06, 2025
- Certificate Expiration Date
- August 05, 2027
- Laboratory Director
- TRACY K. JONES
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Wellstar Douglas Surgical Associates to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1164715132, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 48 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 11 providers are registered at the same or a nearby location.
DOUGLASVILLE, GA 30135
DOUGLASVILLE, GA 30135
DOUGLASVILLE, GA 30135
DOUGLASVILLE, GA 30135
DOUGLASVILLE, GA 30135
DOUGLASVILLE, GA 30135
DOUGLASVILLE, GA 30135
DOUGLASVILLE, GA 30135
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164715132, enumerated as an "organization" on May 24, 2011.
The provider is located at 4904 TIMBER RIDGE DR SUITE 104 DOUGLASVILLE, GA 30135 and the phone number is (770) 942-4822.
Surgery with taxonomy code 208600000X.
