Active NPI
Carrie Rachel Poline, D.O.
- Psychiatry Physician
- Dunwoody, GA
National Provider Identifier
1699988071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 64737
- Practice address
- 4536 Barclay Dr
Dunwoody, GA 30338-7145 - Phone
- (770) 458-8711
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 64737 | GA | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 64737 | GA |
Addresses
Primary practice location
4536 Barclay Dr
Dunwoody, GA 30338-7145
Mailing address
4536 Barclay Dr
Dunwoody, GA 30338-7145
Phone (770) 458-8711
Other names 1
- Dr. Carrie Rachel Mazer-Poline
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64737 | GA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WBC Georgia LLC | Past | Accepting new patients | |
| Unlimited Spectrum, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Atlanta, GA
- NPI 1346610789
-
- Adult Mental Health Clinic/Center
- Atlanta, GA
- NPI 1235674375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288051200000",
"number": "1699988071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4536 BARCLAY DR",
"city": "DUNWOODY",
"state": "GA",
"postal_code": "303387145",
"telephone_number": "770-458-8711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4536 BARCLAY DR",
"city": "DUNWOODY",
"state": "GA",
"postal_code": "303387145",
"telephone_number": "770-458-8711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLINE",
"first_name": "CARRIE",
"middle_name": "RACHEL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2010-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "64737",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "GA",
"license": "64737",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CARRIE",
"last_name": "MAZER-POLINE",
"middle_name": "RACHEL",
"prefix": "DR.",
"credential": "D.O.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Dunwoody, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.