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WELLSTAR NORTH DOUGLAS OB/GYN
NPI 1083910046
Obstetrics & Gynecology in Douglasville, GA

Active since February 08, 2011CLIA 11D0723281 · Waiver
6095 PROFESSIONAL PKWY, SUITE A-210, DOUGLASVILLE, GA 30134(770) 949-4188(770) 949-1614 Get Directions Write a Review

NPPES record last updated: November 18, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wellstar North Douglas Ob/gyn NPPES

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

WELLSTAR NORTH DOUGLAS OB/GYN (NPI 1083910046) is a healthcare organization registered as an obstetrics & gynecology in Douglasville, Georgia and active in the NPI registry since February 2011. The organization holds a CLIA Waiver certificate valid through May 30, 2027 and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1083910046
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameWELLSTAR MEDICAL GROUP, LLC
Location Address6095 PROFESSIONAL PKWY, SUITE A-210Douglasville, GA 30134-5607
Mailing Address6095 Professional Pkwy, Suite A-210Douglasville, GA 30134-5607 · (770) 949-4188 · Fax (770) 949-1614
Phone(770) 949-4188
Fax(770) 949-1614
Organization SubpartYes
Authorized OfficialNicole AsheExecutive Director Of Finance · (470) 644-0095
Enumeration DateFebruary 8, 2011
Last NPPES UpdateNovember 18, 2013
✔ NPI 1083910046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
6095 PROFESSIONAL PKWY, Douglasville, GA 30134
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Other Names 1

Doing Business AsWellstar North Douglas Ob/gyn

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 11D0723281

Wellstar North Douglas Ob Gyn · Douglasville, GA
Active · expires May 30, 2027
CLIA Number11D0723281
Laboratory TypePhysician Office
Certificate Effective DateMay 31, 2025
Certificate Expiration DateMay 30, 2027
Laboratory DirectorNatalie Brathwaite
Laboratory Phone(470) 956-2202
Laboratory LocationWellstar North Douglas Ob Gyn6095 Professional Parkway, Suite A210, Douglasville, GA 30134
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 17

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

DR. BRIDGET DAUPHIN MD
Pediatrics
6095 PROFESSIONAL PKWY, SUITE 100
DOUGLASVILLE, GA 30134
Douglas County (770) 920-2255
DR. SUZANNE LEE FOX MD
Pediatrics
6095 PROFESSIONAL PKWY, SUITE 100
DOUGLASVILLE, GA 30134
Douglas County (770) 920-2255
DR. ETESHAMUL HUQUE MD
Pediatrics
6095 PROFESSIONAL PKWY, SUITE 100
DOUGLASVILLE, GA 30134
Douglas County (770) 920-2255
NORTHWEST DIAGNOSTIC IMAGING, INC
Radiology (Diagnostic Radiology)
6095 PROFESSIONAL PKWY, SUITE 101B
DOUGLASVILLE, GA 30134
Douglas County (770) 947-8100
MS. PAMELA LANDERS PA
Physician Assistant (Medical)
6095 PROFESSIONAL PKWY, SUITE 100
DOUGLASVILLE, GA 30134
Douglas County (770) 920-2255
WELLSTAR NORTH DOUGLAS OB/GYN, LLC
Obstetrics & Gynecology
6095 PROFESSIONAL PKWY, SUITE A 210
DOUGLASVILLE, GA 30134
Douglas County (770) 949-4188
WELLSTAR CREEKSIDE PEDIATRICS, LLC
Pediatrics
6095 PROFESSIONAL PKWY, SUITE 100
DOUGLASVILLE, GA 30134
Douglas County (770) 920-2255
YASSMIN AHMED YOUSEF M.D.
Pediatrics
6095 PROFESSIONAL PKWY, SUITE 100
DOUGLASVILLE, GA 30134
Douglas County (770) 920-2255

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 1083910046. It was assigned to this organization in the NPPES registry on February 8, 2011. The provider is doing business as Wellstar North Douglas Ob/Gyn.

Where is Wellstar Medical Group, LLC located?

Wellstar Medical Group, LLC is located at 6095 Professional Pkwy Suite A-210, Douglasville, GA 30134. The listed phone number is (770) 949-4188.

What is Wellstar Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

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

Yes. A Certificate of Waiver (number 11D0723281) is associated with this NPI, valid through May 30, 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.