KENNESTONE NEUROLOGY ASSOCIATES, P.C. (NPI# 1346453008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346453008 |
| Entity Type | Organization |
| Organization Name | KENNESTONE NEUROLOGY ASSOCIATES, P.C. |
| Practice Address |
711 Canton Rd Ne Suite 210 Marietta GA 30060-8948 |
| Practice Telephone | 7704263977 |
| Practice Fax Number | 7704218567 |
| Mailing Telephone | 7704263977 |
| Mailing Fax Number | 7704218567 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2010-09-08 |
| Authorized Official Name | DR. DAVID R VILLASANA (OWNER) |
| Authorized Official Telephone | 7704263977 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Street Address |
711 CANTON RD NE SUITE 210 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-8948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538144613 | Arif A Aziz | Internal Medicine | 711 Canton Rd Ne, Suite 300, Marietta, GA 30060 | 2005-12-12 |
| 1346610573 | Kendra Denise Jones | Physician Assistant | 711 Canton Rd Ne, Suite 300, Marietta, GA 30060 | 2015-09-30 |
| 1306224779 | Monica Agrawal | Physician Assistant | 711 Canton Rd Ne, Suite 300, Marietta, GA 30060-8948 | 2015-05-18 |
| 1245628601 | Caroline Taylor Schmidtke | Physician Assistant | 711 Canton Rd Ne, Suite 300, Marietta, GA 30060-8948 | 2015-01-07 |
| 1821486523 | Isabell Juliane Wells | Physician Assistant | 711 Canton Rd Ne, Suite 300, Marietta, GA 30060-8948 | 2015-01-03 |
| 1265742191 | Northwest Georgia Anesthesia Associates, LLC | Anesthesiology | 711 Canton Rd Ne, Suite 300, Marietta, GA 30060-8948 | 2010-10-13 |
| 1811208408 | Elizabeth Anne Lintner | Specialist/Technologist, Other | 711 Canton Rd Ne, Suite 400, Marietta, GA 30060-8948 | 2010-06-29 |
| 1083801989 | Heidi R Meyer | Nurse Practitioner | 711 Canton Rd Ne, Suite 210, Marietta, GA 30060-8948 | 2007-09-25 |
| 1497871990 | Advanced Aesthetic Surgery | Surgery | 711 Canton Rd Ne, Suite 400, Marietta, GA 30060-8948 | 2007-03-22 |
| 1801975339 | Gastrointestinal Specialist of Georgia | Internal Medicine | 711 Canton Rd Ne, Suite 300, Marietta, GA 30060-8948 | 2006-11-03 |
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609266634 | Bruce Gillett | Psychiatry & Neurology | 948 Greymont Cir Nw, Marietta, GA 30064-1328 | 2015-01-29 |
| 1033516356 | Neuro Proread Solutions | Psychiatry & Neurology | 2378 Riderwood Court, Marietta, GA 30062-4689 | 2014-12-02 |
| 1578618815 | Jawaid Ahsan | Psychiatry & Neurology | 1000 Johnson Ferry Rd., Bldg. E Ste.220, Marietta, GA 30068-0001 | 2007-01-25 |
| 1215027487 | James A Armstrong | Psychiatry & Neurology | 677 Church St Ne Ste 100, Marietta, GA 30060-1101 | 2006-10-16 |
| 1447351051 | Archana Koganti | Psychiatry & Neurology | 780 Canton Rd Ne Ste 400, Marietta, GA 30060 | 2006-09-26 |
| 1508898669 | Jason A. Soriano | Psychiatry & Neurology | 1960 Regents Way, Marietta, GA 30062 | 2006-07-07 |
| 1902885502 | Daniel Joseph Howley | Psychiatry & Neurology | 400 Matthew St Ste 211, Marietta, OH 45750-1656 | 2006-01-11 |
| 1235128984 | Eliahu S Feen | Psychiatry & Neurology | 677 Church Street, Suite 100n, Marietta, GA 30060 | 2005-10-17 |
| 1053303404 | David Scott Whitcomb | Psychiatry & Neurology | 1521 Johnson Ferry Rd, Suite 135, Marietta, GA 30062-6404 | 2005-08-20 |
| 1619362068 | Zachery Williams Rohm | Psychiatry & Neurology | 677 Church St Ne Ste 100n, Marietta, GA 30060-1101 | 2015-04-02 |
| 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.