NPI age
20 years
Enumerated 2005-12-05
● Active
Type 1 · Individual
Josephine T Ediale, M.D.
Ediale is 1 of 3 pediatrics providers in Villa Rica and 1 of 2726 in Georgia.
Primary specialty
Pediatrics
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2014-10-07
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 2726 active pediatrics providers in Georgia.
NPI age
20 years
↑ 2 yr above median (18 yr)
State licenses
1 state
10% of peers hold multiple states
Subspecialties
0
23% of peers hold subspecialties
NPI lifetime · 2005 → 2026
2005-12Enumerated in NPPES
2005
2026
Where they practice
Practice location
626 Dallas Hwy
Villa Rica, GA 301801209
Mailing address
4480 Blue Ridge Drive
Douglasville, GA 301351800
Specialties
-
Pediatrics PrimaryA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000922732C | |
| 01 (GA) | 000922732 | PEACHSTATE |
| 01 (GA) | 01065140 | AMERIGROUP |
| 01 (GA) | 305728 | WELLCARE |
Practice context
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.