WELLSTAR TOWNE LAKE PEDIATRICS
NPI 1154627115
Pediatrics in Woodstock, GA

Q: What is Wellstar Medical Group, LLC's NPI number?

The NPI number for Wellstar Medical Group, LLC is 1154627115. It was assigned to this organization in the NPPES registry on February 8, 2011. The provider is doing business as Wellstar Towne Lake Pediatrics.

Q: What is Wellstar Medical Group, LLC's specialty?

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

Active since February 08, 2011CLIA 11D0958975 · Waiver

145 N MEDICAL PKWY, WOODSTOCK, GA 30189(770) 517-1900(770) 926-3215 Get Directions Write a Review

NPPES record last updated: November 19, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Wellstar Towne Lake Pediatrics NPPES

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

WELLSTAR TOWNE LAKE PEDIATRICS (NPI 1154627115) is a healthcare organization registered as a pediatrics in Woodstock, Georgia and active in the NPI registry since February 2011. The organization holds a CLIA Waiver certificate valid through December 10, 2027 and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1154627115

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameWELLSTAR MEDICAL GROUP, LLC

Location Address145 N MEDICAL PKWYWoodstock, GA 30189-7031

Mailing Address145 N Medical PkwyWoodstock, GA 30189-7031 · (770) 517-1900 · Fax (770) 926-3215

Phone(770) 517-1900

Fax(770) 926-3215

Organization SubpartYes

Authorized OfficialNicole AsheExecutive Director Of Finance · (470) 644-0095

Enumeration DateFebruary 8, 2011

Last NPPES UpdateNovember 19, 2013

✔ NPI 1154627115 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.

145 N MEDICAL PKWY, Woodstock, GA 30189

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Other Names 1

Doing Business AsWellstar Towne Lake Pediatrics

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 11D0958975

Wellstar Towne Lake Pediatrics · Woodstock, GA

Active · expires Dec 10, 2027

CLIA Number11D0958975

Laboratory TypePhysician Office

Certificate Effective DateDecember 11, 2025

Certificate Expiration DateDecember 10, 2027

Laboratory DirectorMustafa Quraishi

Laboratory Phone(770) 517-1920

Laboratory LocationWellstar Towne Lake Pediatrics145 N Medical Parkway, Woodstock, GA 30189

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. STANLEY R MOGELNICKI MD

Internal Medicine