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

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

Practice location Address checks out

1183 S Hairston Rd Ste A
Stone Mountain, GA 30088-2796
Phone: (404) 296-8858
Show map & directions

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

Other providers in Stone Mountain