WELLSTAR KENMAR PEDIATRICS, LLC - NPI 1346296746

Q: What is Wellstar Kenmar Pediatrics, LLC's NPI number?

The NPI number for Wellstar Kenmar Pediatrics, LLC is 1346296746. It was assigned to this organization in the NPPES registry on May 26, 2006.

Q: What is Wellstar Kenmar Pediatrics, LLC's specialty?

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

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About Wellstar Kenmar Pediatrics, Llc NPPES

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

WELLSTAR KENMAR PEDIATRICS, LLC (NPI 1346296746) is a healthcare organization registered as a pediatrics in Marietta, Georgia and active in the NPI registry since May 2006. The organization holds 2 active CLIA laboratory certificates and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1346296746

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameWELLSTAR KENMAR PEDIATRICS, LLC

Location Address760 KENNESAW AVE NWMarietta, GA 30060-6909

Mailing Address760 Kennesaw Ave NwMarietta, GA 30060-6909 · (770) 427-0183 · Fax (770) 427-0788

Phone(770) 427-0183

Fax(770) 427-0788

Organization SubpartYesParent: Wellstar Health System, Inc.

Authorized OfficialNicole AsheExecutive Director Of Finance · (770) 792-5261

Enumeration DateMay 26, 2006

Last NPPES UpdateJuly 14, 2008

✔ NPI 1346296746 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.

760 KENNESAW AVE NW, Marietta, GA 30060

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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 2

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 11D0667284

Wellstar Kenmar Pediatrics - Marietta · Marietta, GA

Active · expires Oct 31, 2027

CLIA Number11D0667284

Laboratory TypePhysician Office

Certificate Effective DateNovember 1, 2025

Certificate Expiration DateOctober 31, 2027

Laboratory DirectorLarry V. Clements

Laboratory Phone(770) 427-0183

Laboratory LocationWellstar Kenmar Pediatrics - Marietta760 Kennesaw Ave NW, Marietta, GA 30060

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D0964687

Wellstar Kenmar Pediactrics - Ahp · Acworth, GA

Active · expires Feb 1, 2028

CLIA Number11D0964687

Laboratory TypePhysician Office

Certificate Effective DateFebruary 2, 2026

Certificate Expiration DateFebruary 1, 2028

Laboratory DirectorChristian Williams

Laboratory Phone(770) 427-0183

Laboratory LocationWellstar Kenmar Pediactrics - Ahp4550 Cobb Parkway, North, NW, Suite 302, Acworth, GA 30101

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

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

DR. KAYLA FITCH PSYD

Psychologist