East Cobb Foot & Ankle Care P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

630 Issued in GA

Legal business name

EAST COBB FOOT & ANKLE CARE P.C.

Practice address

4439 Roswell Rd
Marietta, GA 30062-6452

Phone

(770) 977-8221

Fax

(770) 977-8222

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark R. Light, DPMNPI 1427055805

Title

Owner

Phone

(770) 977-8221

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark R. Light, DPM

  • Foot & Ankle Surgery Podiatrist
  • Marietta, GA
  • NPI 1427055805
  Medicare reassignment NPD Authorized official
• Robert I Heden, DPM

  • Primary Podiatric Medicine Podiatrist
  • Marietta, GA
  • NPI 1053470732
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243555200000",
    "number": "1184770133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4439 ROSWELL RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626452",
            "telephone_number": "770-977-8221",
            "fax_number": "770-977-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4439 ROSWELL RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626452",
            "telephone_number": "770-977-8221",
            "fax_number": "770-977-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COBB FOOT & ANKLE CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-05-29",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-977-8221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "005480",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000467618B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480034802",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Cobb Cardiology, LLC
• East Cobb Center for Nursing and Healing LLC
• East Cobb Dentistry for Kids
• East Cobb Family Dentistry
• East Cobb Family Dentistry, P.C.
• East Cobb Hand Therapy LLC
• East Cobb Health
• East Cobb Massage Therapy, Inc
• East Cobb Medical Clinic, LLC
• East Cobb MRI Center

• Foot & Ankle Surgery Podiatrist in Marietta, GA
• Providers in Marietta, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.