Cobb Regenerative & Joint Clinic LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

COBB REGENERATIVE & JOINT CLINIC LLC

Practice address

1050 Shiloh Rd NW Ste 305
Kennesaw, GA 30144-8100

Phone

(770) 485-8298

Fax

(770) 234-5215

NPI assigned

May 19, 2021

Organization subpart

No

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

Authorized official

Name

Sixto Gonzalez

Title

Operating Manager/Owner

Phone

(770) 485-8298

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Alicia Malinda Darby-Bishop

  • Family Nurse Practitioner
  • Riverdale, GA
  • NPI 1760092134
  Medicare reassignment NPD

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1053985341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SHILOH RD NW STE 305",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301448100",
            "telephone_number": "770-485-8298",
            "fax_number": "770-234-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SHILOH RD NW STE 305",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301448100",
            "telephone_number": "770-485-8298",
            "fax_number": "770-234-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBB REGENERATIVE & JOINT CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "SIXTO",
        "authorized_official_title_or_position": "OPERATING MANAGER/OWNER",
        "authorized_official_telephone_number": "770-485-8298"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benita R Cloward, M.S. CMHC
• Cobb County Board of Health
• Cobb Medical Supply, Inc
• Cobb Pharmacy, Inc
• Cobb Podiatry, P.C.
• Cobblestone Anesthesia Incorporated
• Cobblestone Surgery Center, Inc.
• Angel M Cobiella, MD MBA
• Cody Comfort Care LLC
• Caitlyn Cofer, PTA

• Pain Medicine (Anesthesiology) Physician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Pain Medicine (Anesthesiology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.

Verify at the official NPI Registry.