Kennestone Heart Physicians Group, PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

131843 Issued in GA

Legal business name

KENNESTONE HEART PHYSICIANS GROUP, PC

Practice address

2513 Shallowford Rd
Building 100
Marietta, GA 30066-6809

Phone

(770) 516-3500

Fax

(770) 516-3660

NPI assigned

Apr 7, 2009

Organization subpart

No

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

Authorized official

Name

Katie Doyle

Title

Manager, Physician Services

Phone

(678) 797-4113

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249344000000",
    "number": "1285877274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609408",
            "telephone_number": "770-426-4721",
            "fax_number": "770-424-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2513 SHALLOWFORD RD",
            "address_2": "BUILDING 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666809",
            "telephone_number": "770-516-3500",
            "fax_number": "770-516-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNESTONE HEART PHYSICIANS GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2009-08-04",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "MANAGER, PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "678-797-4113"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "131843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAR PTAN",
            "identifier": "GRP938",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300025641K",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kennestone Dental Care Center PC
• Kennestone Dental Designs, LLC
• Kennestone Dentist LLC
• Kennestone Family Medicine
• Kennestone Heart Physicians Group
• Kennestone Heart Physicians Group, PC
• Kennestone Hospital Inc
• Kennestone Hospital Inc
• Kennestone Hospital, Inc
• Kennestone Hospital, Inc

• Cardiovascular Disease Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; 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.