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

Edwige Goby Konwo-Tayo

Individual provider Emergency Medicine Physician · NPI 1538646526

Edwige Goby Konwo-Tayo is a Nurse Practitioner in Stone Mountain, Georgia. Qualified in 2017, 9 years ago. Practices with Wellstreet of Georgia PC, a 431-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
9
Licensed in
GA
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

1183 S Hairston Rd Ste A
Stone Mountain, GA 30088-2796
Phone: (404) 296-8858
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN220667 (GA)
Emergency Medicine Physician Taxonomy 207P00000X · Licence RN220667 (GA)

Record details

NPI number1538646526
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 23, 2018
Last updated in NPPESDecember 30, 2019
Certification dateDecember 30, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Wellstreet Of Georgia Pc — 431 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients380
Services billed 1,564 a service is one billed item, such as a visit, a test or a procedure
Average patient age75

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Wellstreet of Georgia PC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 431 clinicians in the practice; 12 are shown here.

Other providers in Stone Mountain