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WELLSTAR CREEKSIDE PEDIATRICS, LLC
NPI 1346296837
Pediatrics in Douglasville, GA

Active since May 26, 2006CLIA Certified · 2 labs
6095 PROFESSIONAL PKWY, SUITE 100, DOUGLASVILLE, GA 30134(770) 920-2255(770) 920-9963 Get Directions Write a Review

NPPES record last updated: July 14, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Wellstar Creekside Pediatrics, Llc NPPES

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

WELLSTAR CREEKSIDE PEDIATRICS, LLC (NPI 1346296837) is a healthcare organization registered as a pediatrics in Douglasville, 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

NPI1346296837
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWELLSTAR CREEKSIDE PEDIATRICS, LLC
Location Address6095 PROFESSIONAL PKWY, SUITE 100Douglasville, GA 30134-5607
Mailing Address6095 Professional Pkwy, Suite 100Douglasville, GA 30134-5607 · (770) 920-2255 · Fax (770) 920-9963
Phone(770) 920-2255
Fax(770) 920-9963
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 1346296837 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.
6095 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 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 11D0707369

Wellstar Creekside Pediatrics · Douglasville, GA
Active · expires Sep 13, 2026
CLIA Number11D0707369
Laboratory TypePhysician Office
Certificate Effective DateSeptember 14, 2024
Certificate Expiration DateSeptember 13, 2026
Laboratory DirectorEtheshamul Huque
Laboratory Phone(770) 920-2255
Laboratory LocationWellstar Creekside Pediatrics6095 Professional Parkway, Suite 100, 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.

Certificate of Waiver 11D2125706

Wellstar Creekside Pediatrics · Douglasville, GA
Active · expires Feb 12, 2027
CLIA Number11D2125706
Laboratory TypePhysician Office
Certificate Effective DateFebruary 13, 2025
Certificate Expiration DateFebruary 12, 2027
Laboratory DirectorEhteshamul Huque
Laboratory Phone(770) 920-2255
Laboratory LocationWellstar Creekside Pediatrics6043 Prestley Mill Road, Suite E, Douglasville, GA 30134
CLIA data matches this NPI record on: Name Phone
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
WELLSTAR MEDICAL GROUP, LLC
Obstetrics & Gynecology
6095 PROFESSIONAL PKWY, SUITE A-210
DOUGLASVILLE, GA 30134
Douglas County (770) 949-4188
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
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 Creekside Pediatrics, LLC's NPI number?

The NPI number for Wellstar Creekside Pediatrics, LLC is 1346296837. It was assigned to this organization in the NPPES registry on May 26, 2006.

Where is Wellstar Creekside Pediatrics, LLC located?

Wellstar Creekside Pediatrics, LLC is located at 6095 Professional Pkwy Suite 100, Douglasville, GA 30134. The listed phone number is (770) 920-2255.

What is Wellstar Creekside Pediatrics, LLC's specialty?

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

Does Wellstar Creekside Pediatrics, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Wellstar Creekside Pediatrics, LLC was last updated on July 14, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.