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WELLSTAR MEDICAL GROUP LLC NPI 1457771925


NPI Information

NPI: 1457771925
Provider Name: WELLSTAR MEDICAL GROUP, LLC

Doing Business As: WELLSTAR PEDIATRIC AFTER HOURS CARE

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 11D2135742

Address:
1180 ERNEST W BARRETT PKWY NW
SUITE 102B
KENNESAW, GA
ZIP 30144
Phone: (678) 354-2273
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WELLSTAR MEDICAL GROUP, LLC is a pediatrics in Kennesaw, GA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. WELLSTAR MEDICAL GROUP, LLC NPI is 1457771925. The provider is registered as an organization entity type.
The provider Is Doing Business As Wellstar Pediatric After Hours Care.

The provider's business location address is:

1180 ERNEST W BARRETT PKWY NW
SUITE 102B
KENNESAW, GA
ZIP 30144-534
Phone: (678) 354-2273
Fax: (770) 794-6837

The provider's authorized official is Nicole Ashe .
The authorized official title is Executive Director Of Finance and has the following contact phone number (470) 644-0095.

The CLIA number assigned to this NPI record is 11D2135742 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/23/2014 and was last updated on 6/10/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QU0200XClinic/CenterUrgent CareGEORGIANo
2208000000XPediatricsGEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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