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WELLSTAR CARDIOVASCULAR MEDICINE, LLC
NPI 1770868531
Internal Medicine - Cardiovascular Disease in Acworth, GA

Active since October 12, 2011CLIA 11D1107553 · Waiver
4900 IVEY RD NW, BLDG 1800 SUITE 1801, ACWORTH, GA 30101(770) 974-8479(770) 974-8710 Get Directions Write a Review

NPPES record last updated: May 9, 2012. Verified against the NPPES registry weekly; last sync: August 09, 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 1770868531) is a healthcare organization registered as a cardiovascular disease in Acworth, Georgia and active in the NPI registry since October 2011. The organization holds a CLIA Waiver certificate valid through November 8, 2027 and lists Barry D Mangel, Chief Cardiology Officer, as its authorized official.

NPPES Registry Identity

NPI1770868531
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameWELLSTAR CARDIOVASCULAR MEDICINE, LLC
Location Address4900 IVEY RD NW, BLDG 1800 SUITE 1801Acworth, GA 30101-4001
Mailing Address55 Whitcher St Ne, Suite 350Marietta, GA 30060-1155 · (770) 424-6893 · Fax (770) 582-9938
Phone(770) 974-8479
Fax(770) 974-8710
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 1770868531 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
4900 IVEY RD NW, Acworth, GA 30101
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Other Identifiers 2

Medicaid386693863AGA
Medicare PIN511G70144GA

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 11D1107553

Wellstar Cardiovascular Medicine -Acworth Health Park · Acworth, GA
Active · expires Nov 8, 2027
CLIA Number11D1107553
Laboratory TypePhysician Office
Certificate Effective DateNovember 9, 2025
Certificate Expiration DateNovember 8, 2027
Laboratory DirectorHans Lee
Laboratory Phone(770) 974-8479
Laboratory LocationWellstar Cardiovascular Medicine -Acworth Health Park4550 Cobb Parkway, NW, Suite 213, Acworth, GA 30101
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 14

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

BRIANNA COLEMAN OTR/L
Occupational Therapist
4900 IVEY RD NW
ACWORTH, GA 30101
Cobb County (770) 917-5737
MOLLIE ARCHER DPT
Physical Therapist
4900 IVEY RD NW, BUILDING 1000 SUITE 1001
ACWORTH, GA 30101
Cobb County (770) 917-0924
JOHN N MURIMI MD
Family Medicine
4900 IVEY RD NW, SUITE 1301
ACWORTH, GA 30101
Cobb County (770) 974-4655
GOVERNORS FAMIILY MEDICAL GROUP, LLC
Family Medicine
4900 IVEY RD NW, SUITE 1826
ACWORTH, GA 30101
Cobb County (770) 975-9077
AMIRA SHAFEY
Family Medicine
4900 IVEY RD NW
ACWORTH, GA 30101
Cobb County (770) 975-9077
LEE BRIAN BRANDT JR. PA
Physician Assistant (Medical)
4900 IVEY RD NW, SUITE 1826
ACWORTH, GA 30101
Cobb County (770) 975-9077
MRS. WILMA BLAKE FAULKNER L.AC., DIPL O.M.
Acupuncturist
4900 IVEY RD NW, SUITE 820
ACWORTH, GA 30101
Cobb County (770) 975-9233
WELLSTAR MEDICAL GROUP, LLC
Family Medicine
4900 IVEY RD NW, SUITE 1301
ACWORTH, GA 30101
Cobb County (770) 975-9077

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 1770868531. It was assigned to this organization in the NPPES registry on October 12, 2011.

Where is Wellstar Cardiovascular Medicine, LLC located?

Wellstar Cardiovascular Medicine, LLC is located at 4900 Ivey Rd NW Bldg 1800 Suite 1801, Acworth, GA 30101. The listed phone number is (770) 974-8479.

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 a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1107553) is associated with this NPI, valid through November 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.