Richard A Bardack, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

012782 Issued in GA

Practice address

55 Whitcher St NE
Suite 350
Marietta, GA 30060-1155

Phone

(770) 424-6893

Fax

(770) 528-9938

NPI assigned

Apr 22, 2009

Last updated

Nov 17, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cobb Hospital, Inc

  dba Wellstar Cobb Hospital

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  NPD (past)

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1538303409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601155",
            "telephone_number": "770-424-6893",
            "fax_number": "770-528-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601155",
            "telephone_number": "770-424-6893",
            "fax_number": "770-528-9938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDACK",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-22",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "012782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000132657P",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000132657R",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000132657L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000132657Q",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000132657M",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000132657O",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000132657N",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juan Nicolas Barajas, MD
• Collin Peter Barbee
• Stephen Barber, MA, LAPC
• Barbour Orthopaedics & Sports Medicine PC
• Maya Barcelli, OTR/L
• Alora Barden
• Benjamin Beryl Barden, M.D.
• Hayley Barden, MAMCHC
• Pooja Bardhan, MD
• Lloyd Richard Bardwell, MD

• Cardiovascular Disease Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.