Individual provider Active NPI

Marla S Tschepikow, MD

  • Internal Medicine Physician
  • Athens, GA
National Provider Identifier
1164623989
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
60887 Issued in GA
Practice address
1500 Oglethorpe Ave Ste 200C
Athens, GA 30606-2165
Phone
(706) 389-3875
Fax
(706) 389-3876
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 60887 GA Primary

Addresses

Primary practice location

1500 Oglethorpe Ave Ste 200C
Athens, GA 30606-2165

Mailing address

PO Box 48089
Athens, GA 30604-8089
Phone (706) 389-3740

Other names 1

  • Marla Shea Buckley Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address communityinternalmedicine@605.direct.myezyaccess.com Direct

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

State licenses

LicenseStateTypeSpecialty
60887GAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1164623989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48089",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306048089",
            "telephone_number": "706-389-3740",
            "fax_number": "706-389-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE STE 200C",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062165",
            "telephone_number": "706-389-3875",
            "fax_number": "706-389-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSCHEPIKOW",
        "first_name": "MARLA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "60887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "communityinternalmedicine@605.direct.myezyaccess.com",
            "affiliation": "N",
            "endpointDescription": "CIMA Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1500 Oglethorpe Ave Ste 200C",
            "city": "Athens",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306062165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARLA",
            "last_name": "BUCKLEY",
            "middle_name": "SHEA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.