WELLSTAR PEDIATRIC & ADOLESCENT CENTER
NPI 1073819124
Pediatrics in Austell, GA
About Wellstar Pediatric & Adolescent Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WELLSTAR PEDIATRIC & ADOLESCENT CENTER (NPI 1073819124) is a healthcare organization registered as a pediatrics in Austell, Georgia and active in the NPI registry since February 2011. The organization holds a CLIA Waiver certificate valid through February 12, 2027 and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
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 Pediatric & Adolescent Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3,854Medicare enrollment records show 3,854 clinicians reassign Medicare billing to Wellstar Pediatric & Adolescent Center, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 1,019 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 79
Nearest to this location (20)
See all 3,854Source: 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 11D0884136
Wellstar Pediatric Adolescent Center - Austell · Austell, GAFrequently 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 1073819124. It was assigned to this organization in the NPPES registry on February 8, 2011. The provider is doing business as Wellstar Pediatric & Adolescent Center.
Where is Wellstar Medical Group, LLC located?
Wellstar Medical Group, LLC is located at 1810 Mulkey Rd Suite 201, Austell, GA 30106. The listed phone number is (770) 819-9262.
What is Wellstar Medical Group, LLC's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
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), 3,854 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, 4 practice at this address and 1,019 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 11D0884136) is associated with this NPI, valid through February 12, 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 18, 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.
# Wellstar Pediatric & Adolescent Center · NPI 1073819124
Pediatrics organization in Austell, Georgia. Organization record, active in the CMS NPPES registry since February 8, 2011.
## Identity
- **NPI:** 1073819124 (Entity type: Organization)
- **Enumerated:** February 8, 2011
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Legal business name:** Wellstar Medical Group, Llc
- **Organization subpart:** Yes (part of Wellstar Medical Group, Llc)
- **Authorized official:** Nicole Ashe, EXECUTIVE DIRECTOR OF FINANCE
## Practice location
- **Address:** 1810 MULKEY RD, SUITE 201, Austell, GA 30106-1151
- **Phone:** (770) 819-9262 · **Fax:** (770) 819-0597
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3,854 clinicians in 79 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (773), Family Practice (246), Internal Medicine (225); 4 practice at this address and 1,019 within 10 miles; [full list](https://npiprofile.com/npi/1073819124/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 18, 2013
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1073819124) · Data from the CMS NPPES public registry.