Joseph L Micca, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

39179 Issued in GA

Practice address

1938 Rand Ridge CT
Marietta, GA 30062-5340

Phone

(770) 888-2524

NPI assigned

Aug 31, 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 identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Cobb Center for Nursing and Healing LLC

  • Skilled Nursing Facility
  • Marietta, GA
  • NPI 1063124766
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1376655712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 RAND RIDGE CT",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625340",
            "telephone_number": "770-888-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 RAND RIDGE CT",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625340",
            "telephone_number": "770-888-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICCA",
        "first_name": "JOSEPH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "39179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00646929C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110140782",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roger A Meyer, M.D., D.D.S.
• Anna Frances Meyerson, M.D.
• Madonna Beth Mezzanotte, LPC
• Mga, LLC
• MGP RX, LLC
• Michael H Mulkey, DMD PC
• Michael L. Leingang, III, DDS, PC
• Michael Petrosky
• Michael S Rappaport PC
• Michael-Renee Godfrey, RN, LPC, PC

• Geriatric Medicine (Internal Medicine) Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.