Organization Active NPI

Marietta Healthcare LLC

  • General Practice Physician
  • Marietta, GA
National Provider Identifier
1447440524
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MARIETTA HEALTHCARE LLC
Practice address
2551 Roswell Rd
Suite 415
Marietta, GA 30062-4762
Phone
(770) 565-2882
Fax
(770) 439-0297
NPI assigned
Jul 26, 2007
Last updated
Jul 26, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Authorized official

Name
Dana Y Paine
Title
Office Manager
Phone
(770) 439-0198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X GA Primary

Addresses

Primary practice location

2551 Roswell Rd
Suite 415
Marietta, GA 30062-4762

Mailing address

2551 Roswell Rd
Suite 415
Marietta, GA 30062-4762
Phone (770) 565-2882

National Provider Directory

National Provider Directory

Locations

2551 Roswell Rd
Ste 415
Marietta, GA 30062
Phone (404) 620-4843

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": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1447440524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 ROSWELL RD",
            "address_2": "SUITE 415",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624762",
            "telephone_number": "770-565-2882",
            "fax_number": "770-439-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 ROSWELL RD",
            "address_2": "SUITE 415",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624762",
            "telephone_number": "770-565-2882",
            "fax_number": "770-439-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIETTA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "PAINE",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-439-0198"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "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 Jul 26, 2007; 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.