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WELLSTAR KENMAR PEDIATRICS
NPI 1992001952
Pediatrics in Marietta, GA

Active since February 08, 2011CLIA 11D2080643 · Waiver
760 KENNESAW AVE NW, MARIETTA, GA 30060(770) 427-0183(770) 427-0788 Get Directions Write a Review

NPPES record last updated: November 18, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wellstar Kenmar Pediatrics NPPES

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

WELLSTAR KENMAR PEDIATRICS (NPI 1992001952) is a healthcare organization registered as a pediatrics in Marietta, Georgia and active in the NPI registry since February 2011. The organization holds a CLIA Waiver certificate valid through February 18, 2028 and lists Nicole Ashe, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1992001952
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWELLSTAR MEDICAL GROUP, 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 SubpartYes
Authorized OfficialNicole AsheExecutive Director Of Finance · (470) 644-0095
Enumeration DateFebruary 8, 2011
Last NPPES UpdateNovember 18, 2013
✔ NPI 1992001952 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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Other Names 1

Doing Business AsWellstar Kenmar 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 11D2080643

Wellstar Medical Group-Kenmar Pediatrics-Barrett · Kennesaw, GA
Active · expires Feb 18, 2028
CLIA Number11D2080643
Laboratory TypePhysician Office
Certificate Effective DateFebruary 19, 2026
Certificate Expiration DateFebruary 18, 2028
Laboratory DirectorRegina Robbins
Laboratory Phone(770) 427-0183
Laboratory LocationWellstar Medical Group-Kenmar Pediatrics-Barrett1605 Collins Road, Kennesaw, GA 30152
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 13

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

DR. KAYLA FITCH PSYD
Psychologist
760 KENNESAW AVE NW
MARIETTA, GA 30060
Cobb County (770) 427-0183
DR. CANDACE HOLLADAY MD
Pediatrics
760 KENNESAW AVE NW
MARIETTA, GA 30060
Cobb County (770) 427-0183
MR. THOMAS JACOB M.D.
Pediatrics
760 KENNESAW AVE NW
MARIETTA, GA 30060
Cobb County (770) 427-0183
DR. CHRISTIAN EDWARD WILLIAMS M.D.
Pediatrics
760 KENNESAW AVE NW
MARIETTA, GA 30060
Cobb County (770) 427-0183
WELLSTAR KENMAR PEDIATRICS, LLC
Pediatrics
760 KENNESAW AVE NW
MARIETTA, GA 30060
Cobb County (770) 427-0183
DR. DEIDRE J GREENE MD
Pediatrics
760 KENNESAW AVE NW
MARIETTA, GA 30060
Cobb County (770) 427-0183
DR. ELIZABETH MCGEE MD
Pediatrics
760 KENNESAW AVE NW
MARIETTA, GA 30060
Cobb County (770) 427-0183
MS. CAROLYN S CHAFFINS CNP
Nurse Practitioner
760 KENNESAW AVE NW
MARIETTA, GA 30060
Cobb County (770) 427-0183

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 1992001952. It was assigned to this organization in the NPPES registry on February 8, 2011. The provider is doing business as Wellstar Kenmar Pediatrics.

Where is Wellstar Medical Group, LLC located?

Wellstar Medical Group, LLC is located at 760 Kennesaw Ave NW, Marietta, GA 30060. The listed phone number is (770) 427-0183.

What is Wellstar Medical Group, LLC's specialty?

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

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

Yes. A Certificate of Waiver (number 11D2080643) is associated with this NPI, valid through February 18, 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 18, 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.