Individual provider Active NPI

Marina Shikhris Wilder, MD

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Marietta, GA
National Provider Identifier
1164468443
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
42000 Issued in GA
Practice address
61 Whitcher St NE
Suite 2150
Marietta, GA 30060-1176
Phone
(770) 422-4268
Fax
(770) 422-2950
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X 042000 GA
Pediatrics Physician 208000000X 042000 GA
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 42000 GA Primary

Addresses

Primary practice location

61 Whitcher St NE
Suite 2150
Marietta, GA 30060-1176

Mailing address

1341 Canton Rd
Suite a
Marietta, GA 30066-6056
Phone (770) 422-0517

Other practice location 1

620 J L White Dr Ste 140B
Jasper, GA 30143-4896
Phone (706) 692-9016

Other names 1

  • Marina S Wilder Former name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000572 GA Practitioner - Undersea and Hyperbaric MedicinePractitioner - Preventive Medicine 1254457096 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Undersea and Hyperbaric Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1266 Hwy 515 S
Jasper, GA 30143-4872
Phone (706) 692-2441

Hospital & facility affiliations

  • Pruitthealth at Home - Gainesville Home health agency, Gainesville, GA, CCN 117129
  • Amedisys Northwest Home Health Home health agency, Jasper, GA, CCN 117064
  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue82
Removal of skin lesions51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42000GAMDUndersea and Hyperbaric Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC CurrentSince Jan 1, 2015 Accepting new patients
Hyperbaric Physicians of Georgia Inc Undersea and Hyperbaric Medicine CurrentSince Aug 1, 2010 Accepting new patients
Cobb Hyperbaric Medicine, Inc Undersea and Hyperbaric Medicine CurrentSince Sep 21, 2015 Accepting new patients
Piedmont Specialty Hospital Billing LLC CurrentSince Mar 1, 2025 Accepting new patients
Hyperbaric Medicine of North Atlanta LLC Undersea and Hyperbaric Medicine PastSince Jul 28, 2024 Accepting new patients

Locations

1505 Northside Blvd
Ste 1300
Cumming, GA 30041
Phone (770) 771-6400

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1266 Highway 515 S
Jasper, GA 30143
Phone (706) 301-5350

61 Whitcher St NE
Ste 2150
Marietta, GA 30060
Phone (770) 422-4268

1341 Canton Rd
Ste A
Marietta, GA 30066

5887 Glenridge Dr
Ste 375
Sandy Springs, GA 30328
Phone (678) 229-2800

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1164468443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 CANTON RD",
            "address_2": "SUITE A",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666056",
            "telephone_number": "770-422-0517",
            "fax_number": "678-638-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE",
            "address_2": "SUITE 2150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601176",
            "telephone_number": "770-422-4268",
            "fax_number": "770-422-2950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 J L White Dr Ste 140B",
            "address_purpose": "LOCATION",
            "city": "Jasper",
            "state": "GA",
            "postal_code": "301434896",
            "country_code": "US",
            "telephone_number": "706-692-9016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDER",
        "first_name": "MARINA",
        "middle_name": "SHIKHRIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "GA",
            "license": "042000",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "042000",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "GA",
            "license": "42000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "WILDER",
            "middle_name": "S",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.