Individual provider Active NPI

Marina Demetrashvili, M.D.

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1144233545
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
051310 Issued in GA
Practice address
206 Edgewood Ave NE
Atlanta, GA 30303-3027
Phone
(404) 616-1858
Fax
(404) 616-1833
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 051310 GA Primary

Addresses

Primary practice location

206 Edgewood Ave NE
Atlanta, GA 30303-3027

Mailing address

4250 River Green Dr NW Apt 402
Atlanta, GA 30327-3090
Phone (404) 869-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144233545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 RIVER GREEN DR NW APT 402",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303273090",
            "telephone_number": "404-869-4444",
            "fax_number": "404-869-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 EDGEWOOD AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033027",
            "telephone_number": "404-616-1858",
            "fax_number": "404-616-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRASHVILI",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "051310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.