Individual provider Active NPI

Mary Leah Woodson, CNM

  • Advanced Practice Midwife
  • Marietta, GA
National Provider Identifier
1104591593
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN206154 Issued in GA
Practice address
699 Church St NE Ste 500
Marietta, GA 30060-1131
Phone
(770) 793-9750
Fax
(770) 919-0581
NPI assigned
Aug 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN206154 GA Primary

Addresses

Primary practice location

699 Church St NE Ste 500
Marietta, GA 30060-1131

Mailing address

699 Church St NE Ste 500
Marietta, GA 30060-1131
Phone (770) 793-9750

Other practice location 1

200 Gentilly Blvd
Cartersville, GA 30120-8504
Phone (470) 490-7200

Other names 1

  • Mary Leah Molineaux Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211028000834 GA Practitioner - Certified Nurse Midwife (CNM) 1456749274 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN206154GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Mar 1, 2022 Accepting new patients

Locations

4550 Cobb Parkway North NW
Ste 301
Acworth, GA 30101
Phone (678) 574-3135

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

699 Church St NE
Ste 500
Marietta, GA 30060
Phone (770) 424-7100

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

Interoperability endpoints

  • Direct secure messaging: lmolineaux445530@directwellstar.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1104591593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 CHURCH ST NE STE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601131",
            "telephone_number": "770-793-9750",
            "fax_number": "770-919-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 CHURCH ST NE STE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601131",
            "telephone_number": "770-793-9750",
            "fax_number": "770-919-0581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Gentilly Blvd",
            "address_purpose": "LOCATION",
            "city": "Cartersville",
            "state": "GA",
            "postal_code": "301208504",
            "country_code": "US",
            "telephone_number": "470-490-7200",
            "fax_number": "770-276-7251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODSON",
        "first_name": "MARY",
        "middle_name": "LEAH",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN206154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MOLINEAUX",
            "middle_name": "LEAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.