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WELLSTAR KENNESTONE PEDIATRIC ASSOCIATES, LLC
NPI 1083660682
Pediatrics in Marietta, GA

Active since May 25, 2006CLIA 11D0705825 · Waiver
1371 CHURCH STREET EXT NE, MARIETTA, GA 30060(770) 422-8315(770) 590-9170 Get Directions Write a Review

NPPES record last updated: July 14, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wellstar Kennestone Pediatric Associates, Llc NPPES

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

WELLSTAR KENNESTONE PEDIATRIC ASSOCIATES, LLC (NPI 1083660682) is a healthcare organization registered as a pediatrics in Marietta, Georgia and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through January 19, 2028 and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1083660682
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWELLSTAR KENNESTONE PEDIATRIC ASSOCIATES, LLC
Location Address1371 CHURCH STREET EXT NEMarietta, GA 30060-7913
Mailing Address1371 Church Street Ext NeMarietta, GA 30060-7913 · (770) 422-8315 · Fax (770) 590-9170
Phone(770) 422-8315
Fax(770) 590-9170
Organization SubpartYesParent: Wellstar Health System, Inc.
Authorized OfficialNicole AsheExecutive Director Of Finance · (770) 792-5261
Enumeration DateMay 25, 2006
Last NPPES UpdateJuly 14, 2008
✔ NPI 1083660682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
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.
1371 CHURCH STREET EXT NE, Marietta, GA 30060
Open in Google Maps ↗

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

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 11D0705825

Wellstar Kennestone Pediatric Associates · Marietta, GA
Active · expires Jan 19, 2028
CLIA Number11D0705825
Laboratory TypePhysician Office
Certificate Effective DateJanuary 20, 2026
Certificate Expiration DateJanuary 19, 2028
Laboratory DirectorManuel Coutinho
Laboratory Phone(770) 422-8315
Laboratory LocationWellstar Kennestone Pediatric Associates121 Marble Mill Road Suite 101, Marietta, GA 30060
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Inpatient Rehabilitation Quality CMS Care Compare

Quality measures, patient outcomes and conditions treated for Wellstar Kennestone Inpatient Rehab (CMS certification number 11T035), from CMS Care Compare.

Wellstar Kennestone Inpatient Rehab

Inpatient rehabilitation facility · Marietta, GA
OwnershipGovernment
CMS Certification Number11T035
Medicare-Certified SinceJuly 1, 1993
Location677 Church StreetMarietta, GA 30060
Phone(770) 793-6696
Rehabilitation unit within a hospital

Conditions Treated

Medicare patient stays by the condition that brought the patient to rehabilitation
Stroke
159
patient stays
Hip or knee replacement, amputation or other bone or joint condition
25
patient stays
Brain injury (traumatic)
19
patient stays
Brain disease or condition (non-traumatic)
18
patient stays
Spinal cord disease or condition (non-traumatic)
17
patient stays
Nervous system disorder (excluding stroke)
16
patient stays
Hip or femur fracture
12
patient stays
Spinal cord injury (traumatic)
Less than 11 patient stays
All other conditions
16
patient stays
Counts reflect Medicare patient stays reported to CMS. CMS reports counts under 11 as "Less than 11" to protect patient privacy.

Quality Measures

Medications reviewed, with follow-up when issues were found
Drug Regimen Review · 285 patient stays
99.6%
Patients given a current list of their medications at discharge
Transfer of Health Information to the Patient · 147 patient stays
98.6%
Medication list sent to the next provider at discharge
Transfer of Health Information to the Provider · 138 patient stays
100%
Patients who meet or exceed the self-care ability expected for their condition at discharge
Discharge Self-Care Score · 243 patient stays
60.1%
Patients who meet or exceed the mobility expected for their condition at discharge
Discharge Mobility Score · 243 patient stays
57.6%
Patients who meet or exceed the overall function expected at discharge
Discharge Function Score · 243 patient stays
58.44%
Patients who experienced one or more falls with major injury during their stay
285 patient stays · Lower rates are better for this measure.
0%
Patients with pressure ulcers or injuries that are new or worsened
Risk-adjusted rate · 285 patient stays · observed rate 1.4% · Lower rates are better for this measure.
1.2%
Healthcare workers given the influenza vaccine
58 healthcare workers
86.2%
Healthcare workers up to date on COVID-19 vaccination
57 healthcare workers
0%
Clostridioides difficile (C. diff) infections
0 observed infections · 1.800 predicted · 5,513 patient days
0.000
standardized infection ratio
No Different than the National Benchmark
Measures are reported under the CMS Inpatient Rehabilitation Facility Quality Reporting Program. Reporting periods vary by measure (October 2021 to December 2023). Measures without current CMS data are not shown.

Discharge, Readmission & Medicare Spending

Patients discharged to home or the community
208 of 304 patient stays · observed rate 68.42%
71.58%
risk-standardized rate
No Different than the National Rate
Potentially preventable readmissions within 30 days after discharge
18 readmissions of 280 patient stays · observed rate 6.43% · Lower rates are better for this measure.
8.39%
risk-standardized rate
No Different than the National Rate
Potentially preventable readmissions during the rehabilitation stay
17 readmissions of 315 patient stays · observed rate 5.4% · Lower rates are better for this measure.
4.98%
risk-standardized rate
No Different than the National Rate
Medicare spending per episode of care
1.00 = national average per episode of care · based on 265 episodes
1.00
spending ratio
Risk-standardized rates account for differences in patient condition mix. Comparison labels are assigned by CMS.

Other Providers at the Same Location NPPES 4

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

AMANDA BOULOS
Physician Assistant (Surgical)
1371 CHURCH STREET EXT NE, SUITE 200
MARIETTA, GA 30060
Cobb County (678) 481-0579
JASON LOMBOY M.D.
Urology
1371 CHURCH STREET EXT NE
MARIETTA, GA 30060
Cobb County (678) 344-8900
LABORATORY CORPORATION OF AMERICA HOLDINGS
Clinical Medical Laboratory
1371 CHURCH STREET EXT NE
MARIETTA, GA 30060
Cobb County (404) 785-8970
ANDREW KENNETH OSTROWSKI M.D.
Urology
1371 CHURCH STREET EXT NE, STE 200
MARIETTA, GA 30060
Cobb County (678) 344-8900

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 Kennestone Pediatric Associates, LLC's NPI number?

The NPI number for Wellstar Kennestone Pediatric Associates, LLC is 1083660682. It was assigned to this organization in the NPPES registry on May 25, 2006.

Where is Wellstar Kennestone Pediatric Associates, LLC located?

Wellstar Kennestone Pediatric Associates, LLC is located at 1371 Church Street Ext NE, Marietta, GA 30060. The listed phone number is (770) 422-8315.

What is Wellstar Kennestone Pediatric Associates, LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Wellstar Kennestone Pediatric Associates, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0705825) is associated with this NPI, valid through January 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Wellstar Kennestone Pediatric Associates, LLC a Medicare-certified inpatient rehabilitation facility?

Yes. Wellstar Kennestone Inpatient Rehab is a Medicare-certified inpatient rehabilitation facility (CMS certification number 11T035), certified since July 1, 1993.

When was this NPI record last updated?

The NPPES record for Wellstar Kennestone Pediatric Associates, LLC was last updated on July 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.