Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Wellstar Kennestone Pediatric Associates, LLC

Organization Pediatrics Physician · NPI 1083660682

Wellstar Kennestone Pediatric Associates, LLC provides Pediatrics Physician services in Marietta, Georgia. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1371 Church Street Ext NE
Marietta, GA 30060-7913 Not confirmed with CMS for 18 years — call before visiting
Phone: (770) 422-8315
Fax: (770) 590-9170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1083660682
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationWellstar Health System, Inc
Authorized official Nicole Ashe — Executive Director Of Finance · (770) 792-5261
NPI enumeratedMay 25, 2006
Last updated in NPPESJuly 14, 2008
Mailing address1371 Church Street Ext Ne, Marietta, GA 30060-7913

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