Active NPI
Roger Harlon Sisk, M.D.
- Pediatrics Physician
- Marietta, GA
National Provider Identifier
1700834504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 021812
- Practice address
- 3600 Dallas Hwy SW
Suite 290
Marietta, GA 30064-1675 - Phone
- (770) 514-8986
- Fax
- (770) 514-0387
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 021812 | GA | Primary |
Addresses
Primary practice location
3600 Dallas Hwy SW
Suite 290
Marietta, GA 30064-1675
Mailing address
3600 Dallas Hwy SW
Suite 290
Marietta, GA 30064-1675
Phone (770) 514-8986
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00205213B | Medicaid | GA |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021812 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Physicians, P.C. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1700834504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 DALLAS HWY SW",
"address_2": "SUITE 290",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300641675",
"telephone_number": "770-514-8986",
"fax_number": "770-514-0387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 DALLAS HWY SW",
"address_2": "SUITE 290",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300641675",
"telephone_number": "770-514-8986",
"fax_number": "770-514-0387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISK",
"first_name": "ROGER",
"middle_name": "HARLON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "021812",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00205213B",
"state": "GA"
}
],
"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 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.