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WELLSTAR UROLOGY
NPI 1467883512
Urology in Marietta, GA

Active since November 27, 2013CLIA Certified · 4 labs
55 WHITCHER ST NE, SUITE 250, MARIETTA, GA 30060(770) 428-4475(770) 426-1499 Get Directions Write a Review

NPPES record last updated: November 27, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wellstar Urology NPPES

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

WELLSTAR UROLOGY (NPI 1467883512) is a healthcare organization registered as an urology in Marietta, Georgia and active in the NPI registry since November 2013. The organization holds 4 active CLIA laboratory certificates and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1467883512
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameWELLSTAR MEDICAL GROUP, LLC
Location Address55 WHITCHER ST NE, SUITE 250Marietta, GA 30060-1155
Mailing Address55 Whitcher St Ne, Suite 250Marietta, GA 30060-1155 · (770) 428-4475 · Fax (770) 426-1499
Phone(770) 428-4475
Fax(770) 426-1499
Organization SubpartYes
Authorized OfficialNicole AsheExecutive Director Of Finance · (470) 644-0095
Enumeration DateNovember 27, 2013
✔ NPI 1467883512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
55 WHITCHER ST NE, Marietta, GA 30060
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Other Names 1

Doing Business AsWellstar Urology

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 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 for Provider-Performed Microscopy Procedures (PPMP) 11D0883816

Wellstar Urology - Douglas · Douglasville, GA
Active · expires Apr 7, 2028
CLIA Number11D0883816
Laboratory TypePhysician Office
Certificate Effective DateApril 8, 2026
Certificate Expiration DateApril 7, 2028
Laboratory DirectorGaspar Msangi
Laboratory Phone(770) 428-4475
Laboratory LocationWellstar Urology - Douglas4904 Timber Ridge Drive Suite 202, Douglasville, GA 30135
CLIA data matches this NPI record on: Name Phone
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 for Provider-Performed Microscopy Procedures (PPMP) 11D2181485

Wellstar Medical Group Urology · Holly Springs, GA
Active · expires Apr 5, 2028
CLIA Number11D2181485
Laboratory TypePhysician Office
Certificate Effective DateApril 6, 2026
Certificate Expiration DateApril 5, 2028
Laboratory DirectorJustin Watson
Laboratory Phone(770) 428-4475
Laboratory LocationWellstar Medical Group Urology1120 Wellstar Way, Suite 302, Holly Springs, GA 30114
CLIA data matches this NPI record on: Name Phone
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 for Provider-Performed Microscopy Procedures (PPMP) 11D2132678

Wellstar Medical Group Urology North Fulton · Roswell, GA
Active · expires Jun 26, 2027
CLIA Number11D2132678
Laboratory TypePhysician Office
Certificate Effective DateJune 27, 2025
Certificate Expiration DateJune 26, 2027
Laboratory DirectorSophia Goodridge
Laboratory Phone(770) 428-4475
Laboratory LocationWellstar Medical Group Urology North Fulton2500 Hospital Blvd, Suite 290, Roswell, GA 30076
CLIA data matches this NPI record on: Name Phone
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 11D2012501

Wellstar Urology West Georgia · Lagrange, GA
Active · expires Sep 6, 2026
CLIA Number11D2012501
Laboratory TypePhysician Office
Certificate Effective DateSeptember 7, 2024
Certificate Expiration DateSeptember 6, 2026
Laboratory DirectorRichard Jadick
Laboratory Phone(770) 428-4475
Laboratory LocationWellstar Urology West Georgia1555 Doctors Drive, Suite 101, Lagrange, GA 30240
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 20

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

DR. ROBERT DAVID JANSEN M.D.
Internal Medicine (Nephrology)
55 WHITCHER ST NE, STE 460
MARIETTA, GA 30060
Cobb County (770) 427-7389
DR. MADHAVI JORDAN MD
Surgery
55 WHITCHER ST NE, SUIT 130
MARIETTA, GA 30060
Cobb County (770) 428-0462
MR. REYES TORRES III PA-C
Physician Assistant
55 WHITCHER ST NE, SUITE 350
MARIETTA, GA 30060
Cobb County (770) 424-6893
ASIF A SABERI M.D.
Internal Medicine (Critical Care Medicine)
55 WHITCHER ST NE, SUITE 160
MARIETTA, GA 30060
Cobb County (770) 422-1372
BRYAN T. PIEDAD M.D.
Internal Medicine (Clinical Cardiac Electrophysiology)
55 WHITCHER ST NE, SUITE 350
MARIETTA, GA 30060
Cobb County (770) 424-6893
MICHAEL J RILEY M.D.
Internal Medicine (Clinical Cardiac Electrophysiology)
55 WHITCHER ST NE, SUITE 350
MARIETTA, GA 30060
Cobb County (770) 424-6893
KAMARA SUZANNE HEARD ACNP
Nurse Practitioner (Acute Care)
55 WHITCHER ST NE
MARIETTA, GA 30060
Cobb County (770) 422-1372
JACLYN WOOD NP
Nurse Practitioner (Family)
55 WHITCHER ST NE, SUITE 250
MARIETTA, GA 30060
Cobb County (770) 428-4475

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 1467883512. It was assigned to this organization in the NPPES registry on November 27, 2013. The provider is doing business as Wellstar Urology.

Where is Wellstar Medical Group, LLC located?

Wellstar Medical Group, LLC is located at 55 Whitcher St NE Suite 250, Marietta, GA 30060. The listed phone number is (770) 428-4475.

What is Wellstar Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Does Wellstar Medical Group, 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 Medical Group, LLC was last updated on November 27, 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.