Cobb County Board of Health

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

COBB COUNTY BOARD OF HEALTH

Practice address

875 Six Flags Dr
Austell, GA 30168-7064

Phone

(678) 385-1360

Fax

(678) 385-1376

NPI assigned

Mar 16, 2006

Organization subpart

No

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

Authorized official

Name

Tyler Carlson, CPA

Title

Director of Administration

Phone

(770) 514-2342

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• South Cobb Public Health Center Doing business as

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1104895572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COUNTY SERVICES PKWY SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300084010",
            "telephone_number": "770-514-2361",
            "fax_number": "770-514-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 SIX FLAGS DR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301687064",
            "telephone_number": "678-385-1360",
            "fax_number": "678-385-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBB COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "770-514-2342",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000456431L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000058616F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "617672014A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Cobb Public Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa T Clinkscales, PAAA
• Thomas Barry Clower, D.M.D,P.C
• Roger Cnossen, PHARMD
• Cobb Anesthesia, PC
• Cobb Center for Radiation Therapy, Inc.
• Cobb County C.U.T.I.E.S, Inc.
• Cobb County Community Services Board
• Cobb County Community Services Board
• Cobb Eye Center, LLP
• Cobb Gynecologist 2 LLC

• All providers in Austell, GA
• Public Health or Welfare Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.