DR. KYLE GRUBBS (NPI# 1487073631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487073631 |
| Entity Type | Individual |
| Full Name | DR. KYLE GRUBBS |
| Credential | M.D. |
| Practice Address |
677 Church St Ne Ste 100n Marietta GA 30060-1101 |
| Practice Telephone | 7704222326 |
| Mailing Telephone | 7704222326 |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2019-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
83117 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1161 21st Avenue South, A-0118 Medical Center North, Nashville, TN 37232 | 6159361567 |
| Street Address |
677 CHURCH ST NE STE 100N |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619362068 | Zachery Williams Rohm | Psychiatry & Neurology | 677 Church St Ne Ste 100n, Marietta, GA 30060-1101 | 2015-04-02 |
| 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 | 2084V0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Vascular Neurology |
| Vascular Neurology is a subspecialty in the evaluation, prevention, treatment and recovery from vascular diseases of the nervous system. This subspecialty includes the diagnosis and treatment of vascular events of arterial or venous origin from a large number of causes that affect the brain or spinal cord such as ischemic stroke, intracranial hemorrhage, spinal cord ischemia and spinal cord hemorrhage. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396993531 | Diogo C. Haussen | Psychiatry & Neurology | 80 Jesse Hill Jr Dr Se # 11c-028, Atlanta, GA 30303-3031 | 2008-08-29 |
| 1255537122 | Samuel K Tsappidi | Psychiatry & Neurology | 1120 15th St # Bi-3076, Augusta, GA 30912-0004 | 2007-06-26 |
| 1104121227 | Alhamza Al-bayati | Psychiatry & Neurology | 1364 Clifton Rd Ne, Atlanta, GA 30322-4500 | 2011-01-20 |
| 1144482803 | Shannon Fredrick Stewart | Psychiatry & Neurology | 11705 Mercy Blvd, Savannah, GA 31419-1711 | 2008-06-25 |
| 1629270848 | Nicolas Antonio Bianchi | Psychiatry & Neurology | 80 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3031 | 2007-06-01 |
| 1326255605 | Aaron M Anderson | Psychiatry & Neurology | 80 Jesse Hill Jr Dr Se, Grady Memorial Hospital Box 036, Atlanta, GA 30303-3031 | 2007-05-17 |
| 1821018201 | Wendy Wright | Psychiatry & Neurology | 1365 Clifton Rd Ne, Suite B6100, Atlanta, GA 30322-1013 | 2006-07-20 |
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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.