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Export Provider Record NPI 1073819124
Wellstar Medical Group, Llc
Organization Subpart: YES
Active
NPI Number1073819124
NPI TypeNPI-2 Organization
SpecialtyPediatrics
Provider Details
NPI1073819124
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2011-02-08
Last Updated2013-11-18
Authorized OfficialNicole Ashe
Executive Director of Finance
Phone: 4706440095
Mailing Address1810 Mulkey Rd, Suite 201
Austell, GA 30106-1151
United States
Phone: (770) 819-9262 | Fax: (770) 819-0597
📍 View Map
Primary Practice Address1810 Mulkey Rd, Suite 201
Austell, GA 30106-1151
United States
Phone: (770) 819-9262 | Fax: (770) 819-0597
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes208000000X – PediatricsGA
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About NPI 1073819124

Wellstar Medical Group, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1073819124. The primary specialty listed is Pediatrics. The organization is located in Austell, GA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2011-02-08. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1073819124?

NPI 1073819124 belongs to Wellstar Medical Group, Llc, a Pediatrics in Austell, GA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1073819124 active?

The current status of NPI 1073819124 in the NPPES registry is Active. The record was last updated on 2013-11-18.

What specialty is NPI 1073819124?

NPI 1073819124 is classified under the taxonomy Pediatrics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1073819124?

You can verify NPI 1073819124 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1073819124?

The primary practice address on file for NPI 1073819124 is 1810 Mulkey Rd, Austell, GA 30106-1151. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1073819124 issued?

NPI 1073819124 was first issued (enumerated) on 2011-02-08. The NPPES record was last updated on 2013-11-18.

Practice Location Map

Wellstar Medical Group, Llc is located at 1810 Mulkey Rd, Austell, GA. Use the map below to find directions or verify the practice location.

📍 1810 Mulkey Rd, Austell, GA 30106-1151  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Wellstar Medical Group, Llc. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-20 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162