WELLSTAR CARDIOVASCULAR MEDICINE, LLC
NPI 1770868531
Internal Medicine - Cardiovascular Disease in Acworth, GA
- Organization
- Internal Medicine
- Cardiovascular Disease
- CLIA Number: 11D1107553
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-08-2027
About WELLSTAR CARDIOVASCULAR MEDICINE, LLC
This page provides the complete NPI Profile along with additional information for Wellstar Cardiovascular Medicine, Llc, an internist established in Acworth, Georgia operating as a Internal Medicine, focusing in cardiovascular disease . The healthcare provider is registered in the NPI registry with number 1770868531 assigned on October 2011. The practitioner's primary taxonomy code is 207RC0000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. Wellstar Cardiovascular Medicine, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Barry D Mangel (Chief Cardiology Officer)
- NPI
- 1770868531 Verify this NPI
- Provider Name
- WELLSTAR CARDIOVASCULAR MEDICINE, LLC
- Entity Type
- Organization
- Location Address
- 4900 IVEY RD NW BLDG 1800 SUITE 1801 ACWORTH, GA 30101
- Location Phone
- (770) 974-8479
- Location Fax
- (770) 974-8710
- Mailing Address
- 55 WHITCHER ST NE SUITE 350 MARIETTA, GA 30060
- Mailing Phone
- (770) 424-6893
- Mailing Fax
- (770) 582-9938
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 10-12-2011
- Last Update Date
- 05-09-2012
- Code Navigator
An internist like Wellstar Cardiovascular Medicine, Llc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
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
Internal Medicine Cardiovascular Disease
- Taxonomy Code
- 207RC0000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 2 | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 386693863A | MEDICAID (05) | GA | |
| 511G70144 | MEDICARE PIN (08) | GA |
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
- 11D1107553
- Facility Type
- Physician Office
- Certificate Effective Date
- November 09, 2025
- Certificate Expiration Date
- November 08, 2027
- Laboratory Director
- HANS LEE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Wellstar Cardiovascular Medicine, Llc 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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Other Providers at the Same Location
The following 14 providers are registered at the same or a nearby location.
ACWORTH, GA 30101
ACWORTH, GA 30101
ACWORTH, GA 30101
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770868531, enumerated as an "organization" on October 12, 2011.
The provider is located at 4900 IVEY RD NW BLDG 1800 SUITE 1801 ACWORTH, GA 30101 and the phone number is (770) 974-8479.
Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
