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WELLSTAR CARDIOVASCULAR MEDICINE, LLC
NPI 1205195724
Internal Medicine - Cardiovascular Disease in Cartersville, GA

Active since May 04, 2012CLIA Certified · 4 labs
40 FOX CHASE, CARTERSVILLE, GA 30120(770) 242-6893(770) 528-9938 Get Directions Write a Review

NPPES record last updated: May 9, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Wellstar Cardiovascular Medicine, Llc NPPES

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

WELLSTAR CARDIOVASCULAR MEDICINE, LLC (NPI 1205195724) is a healthcare organization registered as a cardiovascular disease in Cartersville, Georgia and active in the NPI registry since May 2012. The organization holds 4 active CLIA laboratory certificates and lists Barry D Mangel, Chief Cardiology Officer, as its authorized official.

NPPES Registry Identity

NPI1205195724
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameWELLSTAR CARDIOVASCULAR MEDICINE, LLC
Location Address40 FOX CHASECartersville, GA 30120-2491
Mailing Address55 Whitcher St Ne, Suite350Marietta, GA 30060-1155 · (770) 424-6893 · Fax (770) 528-9938
Phone(770) 242-6893
Fax(770) 528-9938
Organization SubpartYesParent: Wellstar Health System
Authorized OfficialBarry D MangelChief Cardiology Officer · (770) 424-6893
Enumeration DateMay 4, 2012
Last NPPES UpdateMay 9, 2012
✔ NPI 1205195724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedInternal Medicine · Clinical Cardiac ElectrophysiologyTaxonomy 207RC0001X
Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
40 FOX CHASE, Cartersville, GA 30120
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Other Identifiers 2

Medicare PIN5511G701144GA
Medicaid386693863AGA

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 4

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 11D2099089

Wellstar Cardiovascular Medicine-Electrophysiology · Marietta, GA
Active · expires Jul 20, 2027
CLIA Number11D2099089
Laboratory TypePhysician Office
Certificate Effective DateJuly 21, 2025
Certificate Expiration DateJuly 20, 2027
Laboratory DirectorBarry D. Mangel
Laboratory Phone(770) 424-6893
Laboratory LocationWellstar Cardiovascular Medicine-Electrophysiology55 Whitcher Street NE, Ste 160, Marietta, GA 30060
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D1047108

Wellstar Cardiovascular Medicine -Cherokee Health Park · Holly Springs, GA
Active · expires Oct 25, 2027
CLIA Number11D1047108
Laboratory TypePhysician Office
Certificate Effective DateOctober 26, 2025
Certificate Expiration DateOctober 25, 2027
Laboratory DirectorHans Lee
Laboratory Phone(770) 424-6893
Laboratory LocationWellstar Cardiovascular Medicine -Cherokee Health Park1120 Wellstar Way, Suite 303, Holly Springs, GA 30114
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D1013912

Wellstar Cardiovascular Medicine - Austell · Austell, GA
Active · expires Jun 18, 2027
CLIA Number11D1013912
Laboratory TypePhysician Office
Certificate Effective DateJune 19, 2025
Certificate Expiration DateJune 18, 2027
Laboratory DirectorHans Lee
Laboratory Phone(770) 424-6893
Laboratory LocationWellstar Cardiovascular Medicine - Austell1700 Hospital South Drive, Suite 409, Austell, GA 30106
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2056074

Wellstar Cardiovascular Medicine - North Fulton · Roswell, GA
Active · expires Mar 20, 2027
CLIA Number11D2056074
Laboratory TypePhysician Office
Certificate Effective DateMarch 21, 2025
Certificate Expiration DateMarch 20, 2027
Laboratory DirectorJeffrey Sacks
Laboratory Phone(770) 424-6893
Laboratory LocationWellstar Cardiovascular Medicine - North Fulton4500 Hospital Blvd, Suite 320, Roswell, GA 30076
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

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

DR. RICHARD H BRITTON II D.O.
Family Medicine
40 FOX CHASE
CARTERSVILLE, GA 30120
Bartow County (770) 382-0185
ANTONIO V BAUTE, MD, LLC
Internal Medicine (Cardiovascular Disease)
40 FOX CHASE
CARTERSVILLE, GA 30120
Bartow County (770) 500-7162
DR. FRANCISCO PUENTES MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
40 FOX CHASE
CARTERSVILLE, GA 30120
Bartow County (678) 400-2621
KRISTY MARIE HOUGH APRN, FNP-C, FNP-BC
Nurse Practitioner (Family)
40 FOX CHASE
CARTERSVILLE, GA 30120
Bartow County (770) 382-0185
KENNESTONE HEART PHYSICIANS GROUP, PC
Internal Medicine (Cardiovascular Disease)
40 FOX CHASE
CARTERSVILLE, GA 30120
Bartow County (770) 382-0185
STEPHANIE ANN HYSON-GUEVARA PA
Physician Assistant
40 FOX CHASE
CARTERSVILLE, GA 30120
Bartow County (770) 382-0185
FAMILY CARE OF CARTERSVILLE PC
Family Medicine
40 FOX CHASE
CARTERSVILLE, GA 30120
Bartow County (770) 382-0185
ANTONIO V BAUTE MD
Internal Medicine (Cardiovascular Disease)
40 FOX CHASE
CARTERSVILLE, GA 30120
Bartow County (770) 382-0185

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 Cardiovascular Medicine, LLC's NPI number?

The NPI number for Wellstar Cardiovascular Medicine, LLC is 1205195724. It was assigned to this organization in the NPPES registry on May 4, 2012.

Where is Wellstar Cardiovascular Medicine, LLC located?

Wellstar Cardiovascular Medicine, LLC is located at 40 Fox Chase, Cartersville, GA 30120. The listed phone number is (770) 242-6893.

What is Wellstar Cardiovascular Medicine, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does Wellstar Cardiovascular Medicine, LLC hold CLIA laboratory certificates?

Yes. 4 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 Cardiovascular Medicine, LLC was last updated on May 9, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.