MARIETTA PODIATRY GROUP (NPI# 1487638318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487638318 |
| Entity Type | Organization |
| Organization Name | MARIETTA PODIATRY GROUP |
| Practice Address |
165 Vann St Ne Marietta GA 30060-7249 |
| Practice Telephone | 7704229856 |
| Practice Fax Number | 7709840303 |
| Mailing Telephone | 7704229856 |
| Mailing Fax Number | 7709840303 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2012-01-05 |
| Authorized Official Name | DR. GLYN E LEWIS (CEO) |
| Authorized Official Telephone | 7704229856 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP1100X |
Clinic/Center Specialization: Podiatric |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306960836 | Marietta Podiatry Group | Durable Medical Equipment & Medical Supplies | 165 Vann St Ne, Marietta, GA 30060-7249 | 2007-03-19 |
| Street Address |
165 VANN ST NE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-7249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417342700 | Matthew Ward | Podiatrist | 165 Vann St Ne, Marietta, GA 30060 | 2015-04-02 |
| 1427453398 | American Professional Associates, LLC | Podiatrist | 165 Vann St Ne, Marietta, GA 30060-7249 | 2014-11-04 |
| 1932339900 | Daniel Lee Howard | Podiatrist | 165 Vann St Ne, Marietta, GA 30060-7249 | 2009-07-23 |
| 1780870857 | Wellstar North Cobb Women's Health 2 LLC | Clinic/Center | 165 Vann St Ne, Marietta, GA 30060-7249 | 2007-09-21 |
| 1306960836 | Marietta Podiatry Group | Durable Medical Equipment & Medical Supplies | 165 Vann St Ne, Marietta, GA 30060-7249 | 2007-03-19 |
| 1649227661 | Wellstar North Cobb Women's Health, LLC | Obstetrics & Gynecology | 165 Vann St Ne, Marietta, GA 30060-7249 | 2006-05-27 |
| 1548246879 | Matthew Butler | Physical Therapist | 165 Vann St Ne, Marietta, GA 30060-7249 | 2005-12-19 |
| 1407831993 | Glyn E Lewis | Podiatrist | 165 Vann St Ne, Marietta, GA 30060-7249 | 2005-12-07 |
| 1336123264 | Cobb Foot & Leg Surgical Center, LLC | Clinic/Center | 165 Vann St Ne, Marietta, GA 30060-7249 | 2005-12-05 |
| 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 | 261QP1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Podiatric |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104901925 | Windy Hill Podiatry Associates, P.C. | Clinic/Center | 2520 Windy Hill Rd Se, Suite 105, Marietta, GA 30067-8633 | 2006-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184256794 | Whitney Mcconnell LLC | Clinic/Center | 2600 Wildwood Dr, Brunswick, GA 31520-4249 | 2020-02-11 |
| 1801304662 | Hc Podiatry, LLC | Clinic/Center | 1870 The Exchange Se Ste 200, Atlanta, GA 30339-2021 | 2018-01-15 |
| 1508384892 | Eldridge Podiatry and Diabetes Center, LLC | Clinic/Center | 910 Dannon Vw Sw Ste 2201, Atlanta, GA 30331-2156 | 2017-09-06 |
| 1306221106 | Courtney Glenn Dpm LLC | Clinic/Center | 1574 Friendship Rd # 200, Hoschton, GA 30548-4146 | 2015-07-22 |
| 1659516292 | Southside Footcare P.C. | Clinic/Center | 13015 Abercorn St Ste D9, Savannah, GA 31419-1975 | 2008-12-11 |
| 1669626735 | Podiatry Associates of Georgia P C | Clinic/Center | 5200 Greystone Summit Dr, Suite #1010, Columbus, GA 31909-7541 | 2008-11-15 |
| 1588858922 | Webb's Foot and Wound Care Clinic, LLC | Clinic/Center | 2907 Watson Blvd Ste I, #184, Warner Robins, GA 31093-8513 | 2007-08-29 |
| 1154536126 | South Fulton Family Foot Care, Inc. | Clinic/Center | 67 W Campbellton St, Fairburn, GA 30213-1338 | 2007-05-13 |
| 1386869386 | Midtown Surgical Center, LLC | Clinic/Center | 906 Abercorn St, Savannah, GA 31401-5912 | 2007-04-16 |
| 1376668020 | Family Podiatry Center PC | Clinic/Center | 1804 Seminole Drive, Vidalia, GA 30474 | 2007-03-20 |
| Find all providers with the same taxonomy | ||||
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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.