Active NPI
Marissa Maatallah
- Student in an Organized Health Care Education/Training Program
- Atlanta, GA
National Provider Identifier
1922921147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 250 Georgia Ave SE Ste 206
Atlanta, GA 30312-3000 - Phone
- (404) 653-0374
- Fax
- (404) 653-0375
- NPI assigned
- Aug 3, 2026
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
250 Georgia Ave SE Ste 206
Atlanta, GA 30312-3000
Mailing address
9105 Brixworth PL NE
Brookhaven, GA 30319-5336
Phone (601) 941-1613
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785715200000",
"number": "1922921147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9105 BRIXWORTH PL NE",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303195336",
"telephone_number": "601-941-1613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 GEORGIA AVE SE STE 206",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303123000",
"telephone_number": "404-653-0374",
"fax_number": "404-653-0375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAATALLAH",
"first_name": "MARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-03",
"last_updated": "2026-08-03",
"certification_date": "2026-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.