NPIMap

Organization Active NPI

Cobb Medical Associates, LLC

  • Family Medicine Physician
  • Smyrna, GA
National Provider Identifier
1831277987
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COBB MEDICAL ASSOCIATES, LLC
Practice address
3903 S Cobb Dr SE
Suite 200
Smyrna, GA 30080-6342
Phone
(770) 437-6910
Fax
(770) 433-2380
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Donna Jeter
Title
Manager
Phone
(770) 437-6910

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X GA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X GA
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X GA
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X GA
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X GA

Addresses

Primary practice location

3903 S Cobb Dr SE
Suite 200
Smyrna, GA 30080-6342

Mailing address

3903 S Cobb Dr SE
Suite 200
Smyrna, GA 30080-6342
Phone (770) 437-6910

Other identifiers 1

IdentifierTypeStateIssuer
GRP4243OtherGAMEDICARE GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

1779 S 8th St
Ste A
Colorado Springs, CO 80905
Phone (719) 301-7450

4375 Cobb Pkwy SE
Atlanta, GA 30339

1700 Hospital South Dr
Ste 304
Austell, GA 30106
Phone (770) 732-8464

5914 Love St
Austell, GA 30168
Phone (678) 247-6857

1225 Powder Springs St
Marietta, GA 30064
Phone (770) 435-3214

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1831277987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 S COBB DR SE",
            "address_2": "SUITE 200",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806342",
            "telephone_number": "770-437-6910",
            "fax_number": "770-433-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 S COBB DR SE",
            "address_2": "SUITE 200",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806342",
            "telephone_number": "770-437-6910",
            "fax_number": "770-433-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBB MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "JETER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-437-6910"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "GRP4243",
            "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 Mar 6, 2008; 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.