Organization Active NPI

Children'S Carrdiovascular Medicine P.C

  • Pediatric Cardiology Physician
  • Marietta, GA
National Provider Identifier
1003934480
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
CHILDREN'S CARRDIOVASCULAR MEDICINE P.C
Practice address
61 Whitcher St NE
Marietta, GA 30060-1176
Phone
(404) 943-0289
Fax
(404) 943-9787
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Eduardo Montana Jr., M.DNPI 1174554588
Title
Executive Medical Director
Phone
(404) 943-0289

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080P0202X Primary

Addresses

Primary practice location

61 Whitcher St NE
Marietta, GA 30060-1176

Mailing address

61 Whitcher St NE
Marietta, GA 30060-1176
Phone (404) 943-0289

National Provider Directory

National Provider Directory

Locations

4166 Buford Hwy NE
Ste 1102
Atlanta, GA 30345
Phone (404) 785-8150

620 J L White Dr
Ste 110A
Jasper, GA 30143

780 Canton Rd NE
Ste 350
Marietta, GA 30060
Phone (404) 943-0289

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003934480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601176",
            "telephone_number": "404-943-0289",
            "fax_number": "404-943-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601176",
            "telephone_number": "404-943-0289",
            "fax_number": "404-943-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CARRDIOVASCULAR MEDICINE P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONTANA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "EXECUTIVE MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "404-943-0289",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.