Wellstar Medical Group, LLC
NPI 1558664003ActiveOrganization· Family Medicine· Kennesaw, GA
Family Medicine in Kennesaw, Georgia, registered in NPPES in December 2010, part of Wellstar Medical Group, LLC. The authorized official on file is Nicole Ashe, Executive Director Of Finance. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1558664003 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Wellstar Medical Group, LLC |
| NPI issued | Dec 6, 2010 |
| Last updated in NPPES | Nov 19, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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