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

Deja Shari Koenig, NP

Individual provider Family Nurse Practitioner · NPI 1184264525

Deja Shari Koenig, NP is a Nurse Practitioner in Powder Springs, Georgia. Qualified in 2018, 8 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California and Georgia.

Years since qualifying
8
Licensed in
CA, GA
In the registry since
2020
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

4400 Brownsville Rd Ste 105
Powder Springs, GA 30127-8902
Phone: (516) 830-5338
Fax: (470) 523-2573
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1375 Blossom Hill Rd Ste 49, San Jose, CA 95118-3806 — (408) 645-7073
  • 5885 Glenridge Dr Ste 100, Atlanta, GA 30328-5572 — (678) 321-8546

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APRN-NP282683 (GA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 95013548 (CA)

Record details

NPI number1184264525
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJanuary 14, 2020
Last updated in NPPESOctober 29, 2025
Certification dateOctober 29, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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