1. Home
  2. Directory
  3. Georgia
  4. Atlanta
  5. Family Medicine
  6. NPI Profile

WELLSTAR FAMILY MEDICINE AT VININGS JUBILEE
NPI 1710319462
Family Medicine in Atlanta, GA

Active since August 05, 2013CLIA 11D2071354 · Waiver
2850 PACES FERRY RD SE, ATLANTA, GA 30339(678) 556-4950(678) 556-4951 Get Directions Write a Review

NPPES record last updated: November 19, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wellstar Family Medicine At Vinings Jubilee NPPES

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

WELLSTAR FAMILY MEDICINE AT VININGS JUBILEE (NPI 1710319462) is a healthcare organization registered as a family medicine in Atlanta, Georgia and active in the NPI registry since August 2013. The organization holds a CLIA Waiver certificate valid through May 31, 2028 and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1710319462
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWELLSTAR MEDICAL GROUP, LLC
Location Address2850 PACES FERRY RD SEAtlanta, GA 30339-5719
Mailing Address2850 Paces Ferry Rd SeAtlanta, GA 30339-5719 · (678) 556-4950 · Fax (678) 556-4951
Phone(678) 556-4950
Fax(678) 556-4951
Organization SubpartYes
Authorized OfficialNicole AsheExecutive Director Of Finance · (470) 644-0095
Enumeration DateAugust 5, 2013
Last NPPES UpdateNovember 19, 2013
✔ NPI 1710319462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2850 PACES FERRY RD SE, Atlanta, GA 30339
Open in Google Maps ↗

Other Names 1

Doing Business AsWellstar Family Medicine At Vinings Jubilee

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 11D2071354

Wellstar Family Medicine At Vinings Jubilee · Atlanta, GA
Active · expires May 31, 2028
CLIA Number11D2071354
Laboratory TypePhysician Office
Certificate Effective DateJune 1, 2026
Certificate Expiration DateMay 31, 2028
Laboratory DirectorKrystina A. Rowe
Laboratory Phone(678) 556-4950
Laboratory LocationWellstar Family Medicine At Vinings Jubilee2850 Paces Ferry Road, SE, Suite 460, Atlanta, GA 30339
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 2

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

RADHIKA CHENUMOLU RAO D.O.
Family Medicine
2850 PACES FERRY RD SE, SUITE 460
ATLANTA, GA 30339
Cobb County (678) 556-4950
DR. HIMA B. EDUPUGANTI M.D.
Internal Medicine
2850 PACES FERRY RD SE, SUITE 460
ATLANTA, GA 30339
Cobb County (678) 556-4950

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 1710319462. It was assigned to this organization in the NPPES registry on August 5, 2013. The provider is doing business as Wellstar Family Medicine At Vinings Jubilee.

Where is Wellstar Medical Group, LLC located?

Wellstar Medical Group, LLC is located at 2850 Paces Ferry Rd SE, Atlanta, GA 30339. The listed phone number is (678) 556-4950.

What is Wellstar Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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

Yes. A Certificate of Waiver (number 11D2071354) is associated with this NPI, valid through May 31, 2028. 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 19, 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.