NPIMap

Organization Active NPI

Kennestone Neurology Associates, P.C.

  • Neurology Physician
  • Marietta, GA
National Provider Identifier
1346453008
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
KENNESTONE NEUROLOGY ASSOCIATES, P.C.
Practice address
711 Canton Rd NE
Suite 210
Marietta, GA 30060-8948
Phone
(770) 426-3977
Fax
(770) 421-8567
NPI assigned
May 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Authorized official

Name
Dr. David R Villasana, M.D.
Title
Owner
Phone
(770) 426-3977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

711 Canton Rd NE
Suite 210
Marietta, GA 30060-8948

Mailing address

711 Canton Rd NE
Suite 210
Marietta, GA 30060-8948
Phone (770) 426-3977

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1346453008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 CANTON RD NE",
            "address_2": "SUITE 210",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608948",
            "telephone_number": "770-426-3977",
            "fax_number": "770-421-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 CANTON RD NE",
            "address_2": "SUITE 210",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608948",
            "telephone_number": "770-426-3977",
            "fax_number": "770-421-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNESTONE NEUROLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "VILLASANA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-426-3977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; 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.