Individual provider Active NPI

Stanley M Fineman, MD

  • Allergy & Immunology Physician
  • Marietta, GA
National Provider Identifier
1386684207
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
16229 Issued in GA
Practice address
790 Church St NE Ste 150
Marietta, GA 30060-8950
Phone
(770) 953-3331
Fax
(770) 424-4480
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 16229 GA Primary

Addresses

Primary practice location

790 Church St NE Ste 150
Marietta, GA 30060-8950

Mailing address

8200 Roberts Dr Ste 450
Sandy Springs, GA 30350-4115
Phone (770) 952-8612

Other practice location 1

895 Canton Rd NE
Bldg 200 Ste 200
Marietta, GA 30060-8934
Phone (770) 427-1471

Other practice location 2

1519 Johnson Ferry Rd Ste 200
Marietta, GA 30062-6410
Phone (770) 953-3331

Other identifiers 1

IdentifierTypeStateIssuer
00148486AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100825000427 GA Practitioner - Allergy/Immunology 5991829129 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16229GAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Allergy & Asthma Clinic PA Allergy & Immunology CurrentSince Aug 26, 1999 Accepting new patients

Locations

100 Old Ball Ground Hwy
#B
Canton, GA 30114
Phone (770) 720-8000

114 Townpark Dr NW
Ste 240
Kennesaw, GA 30144
Phone (770) 485-3723

1519 Johnson Ferry Rd
Ste 200
Marietta, GA 30062
Phone (770) 973-5578

790 Church St NE
Ste 150
Marietta, GA 30060
Phone (770) 422-4268

8200 Roberts Dr
Ste 450
Sandy Springs, GA 30350

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJBFBA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1386684207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 ROBERTS DR STE 450",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303504115",
            "telephone_number": "770-952-8612",
            "fax_number": "678-803-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHURCH ST NE STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608950",
            "telephone_number": "770-953-3331",
            "fax_number": "770-424-4480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "895 Canton Rd NE",
            "address_2": "Bldg 200 Ste 200",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300608934",
            "country_code": "US",
            "telephone_number": "770-427-1471",
            "fax_number": "770-424-4480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1519 Johnson Ferry Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300626410",
            "country_code": "US",
            "telephone_number": "770-953-3331",
            "fax_number": "770-509-1343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FINEMAN",
        "first_name": "STANLEY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "16229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00148486A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.