Individual provider Active NPI

Alan Maloon, M.D.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Roswell, GA
National Provider Identifier
1093808057
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
031470 Issued in GA
Practice address
11650 Alpharetta Hwy
Suite 100
Roswell, GA 30076-3805
Phone
(470) 365-8855
Fax
(404) 301-4080
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 031470 GA Primary

Addresses

Primary practice location

11650 Alpharetta Hwy
Suite 100
Roswell, GA 30076-3805

Mailing address

11650 Alpharetta Hwy
Suite 100
Roswell, GA 30076-3805
Phone (470) 365-8855

Other practice location 1

780 Canton Rd NE Ste 205
Marietta, GA 30060-7242
Phone (470) 365-8855

Other practice location 2

50 Plaza Way NW Ste B
Marietta, GA 30060-1141
Phone (470) 365-8855

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101119000948 GA Practitioner - Neurology 6103012802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
031470GAMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Neurological Institute for Concussion and Headache Neuromusculoskeletal Medicine & Omm CurrentSince Aug 25, 2019 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

780 Canton Rd NE
Ste 400
Marietta, GA 30060
Phone (770) 422-3602

50 Plaza Way NW
Ste B
Marietta, GA 30060
Phone (470) 365-8855

780 Canton Rd NE
Ste 205
Marietta, GA 30060
Phone (678) 224-6198

11650 Alpharetta Hwy
Ste 100
Roswell, GA 30076
Phone (404) 596-5670

Interoperability endpoints

  • Direct secure messaging: amaloon61932@directwellstar.org

Organizations & group practices 3

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1093808057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 ALPHARETTA HWY",
            "address_2": "SUITE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763805",
            "telephone_number": "470-365-8855",
            "fax_number": "404-301-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 ALPHARETTA HWY",
            "address_2": "SUITE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763805",
            "telephone_number": "470-365-8855",
            "fax_number": "404-301-4080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Canton Rd NE Ste 205",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300607242",
            "country_code": "US",
            "telephone_number": "470-365-8855",
            "fax_number": "404-301-4080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Plaza Way NW Ste B",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601141",
            "country_code": "US",
            "telephone_number": "470-365-8855",
            "fax_number": "404-301-4080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALOON",
        "first_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "GA",
            "license": "031470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.