Active NPI
Welgen One of Georgia LLC
- General Practice Physician
- Lawrenceville, GA
National Provider Identifier
1023746732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- WELGEN ONE OF GEORGIA LLC
- Practice address
- 5415 Sugarloaf Pkwy Ste 1108
Lawrenceville, GA 30043-7832 - Phone
- (833) 935-4361
- NPI assigned
- Aug 10, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shanira Delacruz
- Title
- President
- Phone
- (201) 233-2155
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical & Laboratory Immunology (Allergy & Immunology) Physician | 207KI0005X | |||
| General Practice Physician | 208D00000X | Primary | ||
| Registered Record Administrator | 246YR1600X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
5415 Sugarloaf Pkwy Ste 1108
Lawrenceville, GA 30043-7832
Mailing address
309 E Paces Ferry Rd NE Ste 400
Atlanta, GA 30305-2319
Phone (770) 212-0015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
113 S Perry St
Lawrenceville, GA 30046
629 S 4th St
Ste 301
Louisville, KY 40202
Phone (833) 935-4361
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1568443273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660089600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787788800000",
"number": "1023746732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 E PACES FERRY RD NE STE 400",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303052319",
"telephone_number": "770-212-0015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5415 SUGARLOAF PKWY STE 1108",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300437832",
"telephone_number": "833-935-4361"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELGEN ONE OF GEORGIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-08-10",
"last_updated": "2026-08-27",
"certification_date": "2026-08-27",
"status": "A",
"authorized_official_last_name": "DELACRUZ",
"authorized_official_first_name": "SHANIRA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "201-233-2155"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "207KI0005X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "246YR1600X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Health Information, Registered Record Administrator",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.