Individual provider Active NPI

Michael S McGarry, PHD

  • Psychologist
  • Smyrna, GA
National Provider Identifier
1831139864
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY001263 Issued in GA
Practice address
4015 S Cobb Dr SE
Suite 1
Smyrna, GA 30080-6303
Phone
(770) 435-5453
Fax
(770) 435-9357
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY001263 GA Primary

Addresses

Primary practice location

4015 S Cobb Dr SE
Suite 1
Smyrna, GA 30080-6303

Mailing address

4015 S Cobb Dr SE
Suite 1
Smyrna, GA 30080-6303
Phone (770) 435-5453

Other identifiers 1

IdentifierTypeStateIssuer
00424003AMedicaidGA

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY001263GAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1831139864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 S COBB DR SE",
            "address_2": "SUITE 1",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806303",
            "telephone_number": "770-435-5453",
            "fax_number": "770-435-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 S COBB DR SE",
            "address_2": "SUITE 1",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806303",
            "telephone_number": "770-435-5453",
            "fax_number": "770-435-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGARRY",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY001263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00424003A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.