NPIMap

Organization Active NPI

Joseph L. Micca, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Marietta, GA
National Provider Identifier
1386917425
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
39179 Issued in GA
Legal business name
JOSEPH L. MICCA, MD
Practice address
1938 Rand Ridge CT
Marietta, GA 30062-5340
Phone
(770) 596-7328
Fax
(770) 809-5063
NPI assigned
Feb 21, 2012
Last updated
Feb 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Authorized official

Name
Joseph L Micca, MDNPI 1376655712
Title
Owner
Phone
(770) 888-2524

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 39179 GA Primary

Addresses

Primary practice location

1938 Rand Ridge CT
Marietta, GA 30062-5340

Mailing address

PO Box 3253
Alpharetta, GA 30023-3253
Phone (770) 888-2524

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1386917425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3253",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300233253",
            "telephone_number": "770-888-2524",
            "fax_number": "770-888-2510"
        },
        {
            "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": "770-596-7328",
            "fax_number": "770-809-5063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH L. MICCA, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "MICCA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-888-2524",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "39179",
            "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 Feb 21, 2012; 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.