Robert J Pezzin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21785 Issued in GA

Practice address

102 Wiley Dr
Cedartown, GA 30125-2259

Phone

(770) 748-8940

Fax

(770) 748-2151

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

General Practice

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health Floyd Polk Medical Center Hospital, Cedartown, GA, CCN 111330

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Polk Medical Center, Inc

  • Critical Access Hospital
  • Cedartown, GA
  • NPI 1073927117
  Care Compare affiliation

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1144241944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WILEY DR",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252259",
            "telephone_number": "770-748-8940",
            "fax_number": "770-748-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WILEY DR",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252259",
            "telephone_number": "770-748-8940",
            "fax_number": "770-748-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZIN",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "21785",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "21785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherita Owensby
• Gerald David Palatini Jr., D.D.S.
• Heather Leann Parker
• Pulin Patel, MD
• Faith Payne, LMSW
• Sterly Mary Philip, PT, DPT
• Angelique Laurelyn Pickett, NP-C
• Amanda Leigh Plunkett, PHARMD
• Polk County Board of Health
• Polk County Board of Health

• Family Medicine Physician in Cedartown, GA
• Providers in Cedartown, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.