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WESTSIDE PEDIATRICS, P.C.
NPI 1104049519
Pediatrics in Douglasville, GA

Active since April 11, 2007CLIA 11D0909369 · Waiver
6084 PROFESSIONAL PKWY, SUITE A, DOUGLASVILLE, GA 30134(770) 920-0085(770) 920-0062 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Westside Pediatrics, P.c. NPPES

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

WESTSIDE PEDIATRICS, P.C. (NPI 1104049519) is a healthcare organization registered as a pediatrics in Douglasville, Georgia and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through December 3, 2027 and lists Raju Joseph Kulangara, Owner, as its authorized official.

NPPES Registry Identity

NPI1104049519
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWESTSIDE PEDIATRICS, P.C.
Location Address6084 PROFESSIONAL PKWY, SUITE ADouglasville, GA 30134-5613
Mailing Address6084 Professional Pkwy, Suite ADouglasville, GA 30134-5613 · (770) 920-0085 · Fax (770) 920-0062
Phone(770) 920-0085
Fax(770) 920-0062
Organization SubpartNo
Authorized OfficialRaju Joseph KulangaraOwner · (770) 920-0085
Enumeration DateApril 11, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1104049519 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.
6084 PROFESSIONAL PKWY, Douglasville, GA 30134
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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 11D0909369

Westside Pediatrics PC · Douglasville, GA
Active · expires Dec 3, 2027
CLIA Number11D0909369
Laboratory TypePhysician Office
Certificate Effective DateDecember 4, 2025
Certificate Expiration DateDecember 3, 2027
Laboratory DirectorRaju J. Kulangara
Laboratory Phone(770) 920-0085
Laboratory LocationWestside Pediatrics PC6084 Professional Parkway Suite A, Douglasville, GA 30134
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

EHI PHARMACY SOLUTIONS, LLC.
Non-Pharmacy Dispensing Site
6084 PROFESSIONAL PKWY, STE. B
DOUGLASVILLE, GA 30134
Douglas County (678) 838-4443

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 Westside Pediatrics, P.C.'s NPI number?

The NPI number for Westside Pediatrics, P.C. is 1104049519. It was assigned to this organization in the NPPES registry on April 11, 2007.

Where is Westside Pediatrics, P.C. located?

Westside Pediatrics, P.C. is located at 6084 Professional Pkwy Suite A, Douglasville, GA 30134. The listed phone number is (770) 920-0085.

What is Westside Pediatrics, P.C.'s specialty?

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

Does Westside Pediatrics, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0909369) is associated with this NPI, valid through December 3, 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 Westside Pediatrics, P.C. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.