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WELLSTAR GYNECOLOGIC ONCOLOGY
NPI 1669815817
Obstetrics & Gynecology - Gynecologic Oncology in Austell, GA

Active since April 08, 2013CLIA Certified · 2 labs
1700 HOSPITAL SOUTH DR, SUITE 102, AUSTELL, GA 30106(770) 792-6262(678) 398-1929 Get Directions Write a Review

NPPES record last updated: November 19, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Wellstar Gynecologic Oncology NPPES

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

WELLSTAR GYNECOLOGIC ONCOLOGY (NPI 1669815817) is a healthcare organization registered as a gynecologic oncology in Austell, Georgia and active in the NPI registry since April 2013. The organization holds 2 active CLIA laboratory certificates and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1669815817
Entity TypeOrganization
Primary Taxonomy207VX0201X
Legal Business NameWELLSTAR MEDICAL GROUP, LLC
Location Address1700 HOSPITAL SOUTH DR, SUITE 102Austell, GA 30106-6810
Mailing Address1700 Hospital South Dr, Suite 102Austell, GA 30106-6810 · (770) 792-6262 · Fax (678) 398-1929
Phone(770) 792-6262
Fax(678) 398-1929
Organization SubpartYes
Authorized OfficialNicole AsheExecutive Director Of Finance · (470) 644-0095
Enumeration DateApril 8, 2013
Last NPPES UpdateNovember 19, 2013
✔ NPI 1669815817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Gynecologic OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207VX0201X
Definition
An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.
1700 HOSPITAL SOUTH DR, Austell, GA 30106
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Other Names 1

Doing Business AsWellstar Gynecologic Oncology

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 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 of Waiver 11D2312892

Wellstar Gynecologic Oncology Vhp · Smyrna, GA
Active · expires Oct 20, 2026
CLIA Number11D2312892
Laboratory TypePhysician Office
Certificate Effective DateOctober 21, 2024
Certificate Expiration DateOctober 20, 2026
Laboratory DirectorTyler Woodard
Laboratory Phone(770) 792-6262
Laboratory LocationWellstar Gynecologic Oncology Vhp4441 Atlanta Road, Suite 319, Smyrna, GA 30080
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2105537

Wellstar Medical Group Gynecologic Oncology · Marietta, GA
Active · expires Sep 18, 2026
CLIA Number11D2105537
Laboratory TypePhysician Office
Certificate Effective DateSeptember 19, 2024
Certificate Expiration DateSeptember 18, 2026
Laboratory DirectorAmy R. Carroll
Laboratory Phone(770) 792-6262
Laboratory LocationWellstar Medical Group Gynecologic Oncology699 Church Street, Suite 235, Marietta, GA 30060
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.

MS. COLETTE M TETREAULT CNM
Advanced Practice Midwife
1700 HOSPITAL SOUTH DR, SUITE 500
AUSTELL, GA 30106
Cobb County (770) 941-7717
THE HEART CLINIC, P.C.
Internal Medicine (Cardiovascular Disease)
1700 HOSPITAL SOUTH DR, SUITE 302
AUSTELL, GA 30106
Cobb County (770) 739-0999
MRS. STEPHANIE R BONHAUS CNM
Advanced Practice Midwife
1700 HOSPITAL SOUTH DR, SUITE 500
AUSTELL, GA 30106
Cobb County (771) 941-7717
EMILY A GOOLSBY CNM
Advanced Practice Midwife
1700 HOSPITAL SOUTH DR, SUITE 500
AUSTELL, GA 30106
Cobb County (770) 941-7717
MR. MICHAEL DAMIEN RODRIGUEZ MSW
Social Worker (Clinical)
1700 HOSPITAL SOUTH DR, SUITE 102
AUSTELL, GA 30106
Cobb County (770) 948-3233
DR. JACOB NATHAN BLATT M.D.
Internal Medicine (Clinical Cardiac Electrophysiology)
1700 HOSPITAL SOUTH DR, SUITE 409
AUSTELL, GA 30106
Cobb County (770) 424-6893
JEFFREY F HINES MD
Obstetrics & Gynecology (Gynecologic Oncology)
1700 HOSPITAL SOUTH DR, SUITE 102
AUSTELL, GA 30106
Cobb County (770) 792-6262
DR. MICAH R. TEPPER M.D.
Internal Medicine (Cardiovascular Disease)
1700 HOSPITAL SOUTH DR, SUITE 409
AUSTELL, GA 30106
Cobb County (770) 732-9100

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 1669815817. It was assigned to this organization in the NPPES registry on April 8, 2013. The provider is doing business as Wellstar Gynecologic Oncology.

Where is Wellstar Medical Group, LLC located?

Wellstar Medical Group, LLC is located at 1700 Hospital South Dr Suite 102, Austell, GA 30106. The listed phone number is (770) 792-6262.

What is Wellstar Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecologic Oncology, with taxonomy code 207VX0201X.

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.