OrganizationActive
Wellstar Medical Group, LLC
NPI 1457771925 · Pediatrics Physician · Kennesaw, GA
Provider details
- NPI number
- 1457771925
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Wellstar Medical Group, LLC
- Organization subpart
- Yes
- Authorized official
- Nicole Ashe, Executive Director of Finance(470) 644-0095
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Urgent Care Clinic/Center261QU0200X
Ambulatory Health Care Facilities
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1180 Ernest W Barrett Pkwy Nw
Suite 102b
Kennesaw, GA 30144-4534
Phone: (678) 354-2273
Fax: (770) 794-6837
Street-level locationGet directions
Mailing address
1180 Ernest W Barrett Pkwy Nw
Kennesaw, GA 30144-4534
Other names (DBA / former)
- Doing business as
- Wellstar Pediatric After Hours Care
Registry dates
- Enumerated
- 2014-04-23
- Last updated
- 2015-06-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.