WELLSTAR CARDIOVASCULAR MEDICINE, LLC
NPI 1750666525
Internal Medicine - Cardiovascular Disease in Marietta, GA

Q: 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.

Active since October 12, 2011CLIA 11D2080864 · Waiver

1010 JOHNSON FERRY RD, MARIETTA, GA 30068(770) 321-3490(770) 321-3489 Get Directions Write a Review

NPPES record last updated: May 9, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Wellstar Cardiovascular Medicine, Llc NPPES

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

WELLSTAR CARDIOVASCULAR MEDICINE, LLC (NPI 1750666525) is a healthcare organization registered as a cardiovascular disease in Marietta, Georgia and active in the NPI registry since October 2011. The organization holds a CLIA Waiver certificate valid through July 15, 2028 and lists Barry D Mangel, Chief Cardiology Officer, as its authorized official.

NPPES Registry Identity

NPI1750666525

Entity TypeOrganization

Primary Taxonomy207RC0000X

Legal Business NameWELLSTAR CARDIOVASCULAR MEDICINE, LLC

Location Address1010 JOHNSON FERRY RDMarietta, GA 30068-2108

Mailing Address55 Whitcher St Ne, Suite 350Marietta, GA 30060-1155 · (770) 242-6893 · Fax (770) 528-9938

Phone(770) 321-3490

Fax(770) 321-3489

Organization SubpartYesParent: Wellstar Health System, Inc.

Authorized OfficialBarry D MangelChief Cardiology Officer · (770) 424-6893

Enumeration DateOctober 12, 2011

Last NPPES UpdateMay 9, 2012

✔ NPI 1750666525 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

1010 JOHNSON FERRY RD, Marietta, GA 30068

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Other Identifiers 2

Medicare PIN511G701144GA

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

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 11D2080864

Wellstar Cardiovascular Medicine · Marietta, GA

Active · expires Jul 15, 2028

CLIA Number11D2080864

Laboratory TypePhysician Office

Certificate Effective DateJuly 16, 2026

Certificate Expiration DateJuly 15, 2028

Laboratory DirectorLee Hans

Laboratory Phone(770) 321-3490

Laboratory LocationWellstar Cardiovascular Medicine3747 Roswell Road NE, Suite 213, Marietta, GA 30062

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. YEN-I GRACE CHEN M.D.

Family Medicine