DR. SHAYA TAGHECHIAN (NPI# 1053612101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053612101 |
| Entity Type | Individual |
| Full Name | DR. SHAYA TAGHECHIAN |
| Credential | MD |
| Practice Address |
790 Church St Ne Suite 430 Marietta GA 30060-7282 |
| Mailing Address |
1930 Brannan Rd Mcdonough GA 30253-4310 |
| Practice Telephone | 7704299100 |
| Practice Fax Number | 7704291391 |
| Mailing Telephone | 6782844040 |
| Mailing Fax Number | 6782844076 |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2020-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 65188 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | FT2339439 | 01 | |
| GA | 003110961A | 05 |
| Street Address |
790 CHURCH ST NE SUITE 430 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-7282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720083702 | Roberto A. Larrivey | Otolaryngology | 790 Church St Ne, Ste 140, Marietta, GA 30060-8902 | 2005-06-16 |
| 1003356361 | Proactive Physicians of Marietta, PC | Clinic/Center | 790 Church St Ne, Suite 220, Marietta, GA 30060-7282 | 2017-03-06 |
| 1720535529 | Tracy Zoblisein | Pharmacist | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2016-09-09 |
| 1609323641 | Lisa Long | Pharmacist | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2016-09-07 |
| 1306293113 | Kristina L Thomas | Nurse Practitioner | 790 Church St Ne, Suite 150, Marietta, GA 30060-7282 | 2016-05-21 |
| 1447681218 | James Wesley Garrett | Physician Assistant | 790 Church St Ne, Ste 400, Marietta, GA 30060-7282 | 2013-12-04 |
| 1396083606 | Deborah Luann Hurd | Nurse Practitioner | 790 Church St Ne, Suite 330, Marietta, GA 30060-7282 | 2013-01-21 |
| 1336485457 | Paradigm Medical LLC | Specialist | 790 Church St Ne, Suite 410, Marietta, GA 30060-7282 | 2012-12-18 |
| 1679824742 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2012-09-28 |
| 1568724052 | Brandon M Paritz | Family Medicine | 790 Church St Ne, Suite 250, Marietta, GA 30060-7282 | 2012-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447772348 | Georgia Urology Pa | Urology | 4800 Olde Towne Pkwy Ste 220, Marietta, GA 30068-4391 | 2017-07-12 |
| 1922185842 | Thomas H. Chun | Urology | 55 Whitcher St # 250, Marietta, GA 30060 | 2006-11-01 |
| 1346342128 | A Keith Levinson | Urology | 55 Whitcher St Ne Ste 250, Marietta, GA 30060-1169 | 2006-09-02 |
| 1669440814 | Carson Wong | Urology | 400 Matthew St Ste 303, Marietta, OH 45750-1656 | 2006-03-12 |
| 1225033442 | James S Goodlet Jr. | Urology | 185 Blair Valley Dr Ne, Marietta, GA 30060-8033 | 2005-06-15 |
| 1679951180 | Anand Badri | Urology | 55 Whitcher St Ne Ste 250, Marietta, GA 30060-1169 | 2015-05-16 |
| 1841619152 | Daniel Mollengarden | Urology | 55 Whitcher St Ne Ste 250, Marietta, GA 30060 | 2014-04-15 |
| 1881012391 | Akash A. Kapadia | Urology | 55 Whitcher St Ne Ste 250, Marietta, GA 30060-1169 | 2014-04-01 |
| 1467883512 | Wellstar Medical Group, LLC | Urology | 55 Whitcher St Ne, Suite 250, Marietta, GA 30060-1155 | 2013-11-27 |
| 1659711547 | Reena Kabaria | Urology | 55 Whitcher St Ne Ste 250, Marietta, GA 30060 | 2013-06-25 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.