Todd William Iwanicki, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

039598 Issued in GA

Practice address

3580 Piedmont Rd NE # 215
Atlanta, GA 30305-1506

Phone

(404) 800-5744

Fax

(404) 777-2931

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Todd William Iwanicki Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1235297599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 PIEDMONT RD NE # 215",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051506",
            "telephone_number": "404-800-5744",
            "fax_number": "404-777-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 PIEDMONT RD NE # 215",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051506",
            "telephone_number": "404-800-5744",
            "fax_number": "404-777-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWANICKI",
        "first_name": "TODD",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "039598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TODD",
            "last_name": "IWANICKI",
            "middle_name": "WILLIAM",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tyler Marie Ivory, MD
• Deja Ivy, MS, RD , LD
• Alexander Taro Iwamoto, MD
• Sally Williams Iwamoto, M.D.
• Isabella Iwanicki
• Kathryn Iwasaki, PA-C
• Kingsley Iwudibia, PHARMD
• Violet I Iyahen
• Sampada Iyengar
• Srikant Iyer, MD

• Psychiatry Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.