Marvin D Tark, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

018257 Issued in GA

Practice address

400 Tower Road
Suite 350
Marietta, GA 30060-9415

Phone

(770) 590-1078

Fax

(770) 422-7306

NPI assigned

Aug 16, 2006

Last updated

Apr 8, 2011By the provider in NPPES

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 1

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

Locations

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.

• The Interventional Spine and Pain Management Center, PC

  dba Alliance Spine and Pain Centers

  • Interventional Pain Medicine Physician
  • Conyers, GA
  • NPI 1518012004
  Medicare reassignment NPD
• The Interventional Spine and Pain Management Center PC

  dba Alliance Spine and Pain Centers

  • Interventional Pain Medicine Physician
  • Cumming, GA
  • NPI 1447963608
  NPD
• Georgia Anesthesiologists, PC

  • Anesthesiology Physician
  • Woodstock, GA
  • NPI 1740299197

  Interventional Pain Medicine

  NPD (past)
• Georgia Pain Spine Center

  • Ambulatory Surgical Clinic/Center
  • Cartersville, GA
  • NPI 1750494423
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1548373210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TOWER RD NE",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609415",
            "telephone_number": "770-590-1078",
            "fax_number": "770-422-7306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TOWER ROAD",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609415",
            "telephone_number": "770-590-1078",
            "fax_number": "770-422-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARK",
        "first_name": "MARVIN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "018257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000155339E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tapestry Psychological Associates
• Tapestry Psychological Associates, Inc
• John Michael Tarantino, CSFA
• Tariq Javed, M.D., P.C.
• Haaroon Tariq, MD
• Natalie Tarpley, ATC, LAT, OTC
• Marianne Taryla, MD
• Bella Chandrashekhar Tase, OTR
• Stuart R Tasman, OD
• Ashenafi Tassew, MD

• Interventional Pain Medicine Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.