WELLSTAR ACWORTH FAMILY PRACTICE
NPI 1942506654
Family Medicine in Acworth, GA

Active since January 28, 2011CLIA 11D0987106 · Waiver
4550 COBB PARKWAY NORTH NW, SUITE 201, ACWORTH, GA 30101(770) 974-4655(770) 974-7534 Get Directions Write a Review

NPPES record last updated: November 19, 2013. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Wellstar Acworth Family Practice NPPES

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

WELLSTAR ACWORTH FAMILY PRACTICE (NPI 1942506654) is a healthcare organization registered as a family medicine in Acworth, Georgia and active in the NPI registry since January 2011. The organization holds a CLIA Waiver certificate valid through May 28, 2027 and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1942506654
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWELLSTAR MEDICAL GROUP, LLC
Location Address4550 COBB PARKWAY NORTH NW, SUITE 201Acworth, GA 30101-4180
Mailing Address4550 Cobb Parkway North Nw, Suite 201Acworth, GA 30101-4180 · (770) 974-4655 · Fax (770) 974-7534
Fax(770) 974-7534
Organization SubpartYes
Authorized OfficialNicole AsheExecutive Director Of Finance · (470) 644-0095
Enumeration DateJanuary 28, 2011
Last NPPES UpdateNovember 19, 2013
✔ NPI 1942506654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4550 COBB PARKWAY NORTH NW, Acworth, GA 30101

Other Names 1

Doing Business AsWellstar Acworth Family Practice

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wellstar Acworth Family Practice is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3,852

Medicare enrollment records show 3,852 clinicians reassign Medicare billing to Wellstar Acworth Family Practice, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 108 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 79

Nurse Practitioner773
Family Practice246
Internal Medicine225
Hospitalist215
Obstetrics/Gynecology165
Pediatric Medicine165
Certified Registered Nurse Anesthetist (CRNA)153
Anesthesiology151
71 other specialties1,759

Nearest to this location (20)

See all 3,852
Nurse Practitioner
NPI 1104281187
4550 COBB PARKWAY NW
Acworth, GA 30301
(470) 956-0150
✔ PECOS✔ Accepts MedicareSame address
Gastroenterology
NPI 1114458502
4550 COBB PARKWAY NORTH NW STE 210B
Acworth, GA 30101
(470) 267-1760
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1255296976
4550 COBB PARKWAY NORTH NW
Acworth, GA 30101
(470) 956-0050
✔ PECOS✔ Accepts MedicareSame address
Pulmonary Disease
NPI 1396129607
4550 COBB PARKWAY NORTH NW STE 210
Acworth, GA 30101
(770) 422-1372
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1497308506
4550 COBB PARKWAY NORTH NW STE 201A
Acworth, GA 30101
(770) 974-4655
✔ PECOS✔ Accepts MedicareSame address
Clinical Social Worker
NPI 1861205668
4550 COBB PARKWAY NORTH NW STE 201A
Acworth, GA 30101
(770) 974-4655
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1861832362
4550 COBB PARKWAY NORTH NW STE 101
Acworth, GA 30101
(770) 917-8140
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1740819788
4550 COBB PARKWAY NORTH NW STE 201A
Acworth, GA 30101
(770) 974-4655
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1255871562
4550 COBB PARKWAY NORTH NW STE 201A
Acworth, GA 30101
(770) 974-4655
✔ PECOS0.1 mi
Pediatric Medicine
NPI 1790756872
4550 COBB PARKWAY NORTH NW STE 302
Acworth, GA 30101
(770) 427-0183
✔ PECOS0.1 mi
Pulmonary Disease
NPI 1639259666
4550 COBB PARKWAY NORTH NW STE 210
Acworth, GA 30101
(770) 422-1372
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1821745704
4550 COBB PARKWAY NORTH NW STE 101
Acworth, GA 30101
(470) 956-0100
✔ PECOS✔ Accepts Medicare0.1 mi
Pulmonary Disease
NPI 1972998730
4550 COBB PARKWAY NORTH NW STE 210
Acworth, GA 30101
(770) 422-1372
✔ PECOS✔ Accepts Medicare0.1 mi
Family Practice
NPI 1013276765
4550 COBB PARKWAY NORTH NW STE 201A
Acworth, GA 30101
(770) 974-4655
✔ PECOS✔ Accepts Medicare0.1 mi
Family Practice
NPI 1659378412
4550 COBB PARKWAY NORTH NW STE 101
Acworth, GA 30101
(470) 956-0100
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1275183923
4550 COBB PARKWAY NORTH NW STE 101
Acworth, GA 30101
(770) 917-8140
✔ PECOS✔ Accepts Medicare0.1 mi
Qualified Audiologist
NPI 1689796963
4550 COBB PARKWAY NORTH NW
Acworth, GA 30101
(770) 505-7190
✔ Accepts Medicare0.1 mi
Hand Surgery
NPI 1962680991
4550 COBB PARKWAY NORTH NW SUITE #309B
Acworth, GA 30101
(770) 917-6795
✔ PECOS✔ Accepts Medicare0.1 mi
Cardiovascular Disease (Cardiology)
NPI 1629133103
4550 COBB PARKWAY NORTH NW SUITE 213
Acworth, GA 30101
(770) 974-8479
✔ PECOS✔ Accepts Medicare0.1 mi
Gastroenterology
NPI 1649627357
4550 COBB PARKWAY NORTH NW STE 210B
Acworth, GA 30101
(470) 267-1760
✔ PECOS✔ Accepts Medicare0.1 mi
See all 3,852 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 11D0987106

Wellstar Acworth Family Practice · Acworth, GA
Active · expires May 28, 2027
CLIA Number11D0987106
Laboratory TypePhysician Office
Certificate Effective DateMay 29, 2025
Certificate Expiration DateMay 28, 2027
Laboratory DirectorJohn N. Murimi
Laboratory Phone(770) 974-4655
Laboratory LocationWellstar Acworth Family Practice4550 Cobb Parkway, North, Suite 201 A, Acworth, GA 30101
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1942506654. It was assigned to this organization in the NPPES registry on January 28, 2011. The provider is doing business as Wellstar Acworth Family Practice.

Where is Wellstar Medical Group, LLC located?

Wellstar Medical Group, LLC is located at 4550 Cobb Parkway North NW Suite 201, Acworth, GA 30101. The listed phone number is (770) 974-4655.

What is Wellstar Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Wellstar Medical Group, LLC enrolled in Medicare?

Yes. Wellstar Medical Group, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wellstar Medical Group, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3,852 clinicians in 79 Medicare specialties reassign their Medicare billing to Wellstar Medical Group, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (773), Family Practice (246) and Internal Medicine (225). Of these, 8 practice at this address and 108 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Wellstar Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0987106) is associated with this NPI, valid through May 28, 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 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.