OrganizationActive
Decatur Pediatric Group, PA
NPI 1619029592 · Pediatrics Physician · Clarkston, GA
Decatur Pediatric Group, PA is a Pediatrics Physician organization in Clarkston, GA (NPI 1619029592).
Provider details
- NPI number
- 1619029592
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lynette Wilson-Phillips, President(404) 296-7133
- License
- 038132 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
4112 E Ponce De Leon Ave
Clarkston, GA 30021-1817
Phone: (404) 296-7133
Fax: (404) 296-7211
Street-level locationGet directions
Mailing address
4112 E Ponce De Leon Ave
Clarkston, GA 30021-1817
Registry dates
- Enumerated
- 2007-01-18
- Last updated
- 2020-08-22
Frequently asked questions
- What is Decatur Pediatric Group, PA's NPI number?
- Decatur Pediatric Group, PA's National Provider Identifier (NPI) is 1619029592, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Decatur Pediatric Group, PA?
- Decatur Pediatric Group, PA is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Decatur Pediatric Group, PA located?
- Decatur Pediatric Group, PA's practice location on file with NPPES is 4112 E Ponce De Leon Ave, Clarkston, GA 30021-1817.
- What is Decatur Pediatric Group, PA's phone number?
- The practice phone number listed in the NPPES registry for Decatur Pediatric Group, PA is (404) 296-7133.
- Who is the authorized official for Decatur Pediatric Group, PA?
- The authorized official listed on Decatur Pediatric Group, PA's NPPES record is Lynette Wilson-Phillips, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Decatur Pediatric Group, PA's NPI active?
- Yes — Decatur Pediatric Group, PA's NPI (1619029592) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.