PROACTIVE PHYSICIANS OF MARIETTA, PC (NPI# 1003356361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003356361 |
Entity Type | Organization |
Organization Name | PROACTIVE PHYSICIANS OF MARIETTA, PC |
Practice Address |
790 Church St Ne Suite 220 Marietta GA 30060-7282 |
Practice Telephone | 6787539300 |
Practice Fax Number | 6787539300 |
Mailing Telephone | 6787539300 |
Mailing Fax Number | 6787539300 |
Enumeration Date | 2017-03-06 |
Last Update Date | 2017-03-06 |
Authorized Official Name | DR. RICHARD SCOTT MILLS (COO) |
Authorized Official Telephone | 6787942216 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
Street Address |
790 CHURCH ST NE SUITE 220 |
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 |
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 |
1073870093 | Physicians Spine & Rehabilitation Specialists of Georgiapc | Pain Medicine | 790 Church St Ne, Suite 550, Marietta, GA 30060-7282 | 2012-04-16 |
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 | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043861545 | Careatc | Clinic/Center | 2130 Northwest Pkwy Se Ste H, Marietta, GA 30067-9307 | 2019-09-25 |
1205388980 | Careatc-quicktrip Atlanta-glenridge | Clinic/Center | 2130 Northwest Pkwy Se, Suite H, Marietta, GA 30067-9307 | 2016-10-28 |
1083071773 | Irshad Syed Md LLC | Clinic/Center | 2382 Monte Villa Cts, Marietta, GA 30062-2899 | 2016-01-26 |
1144500117 | Ann Drake Thomas M.d.,p.c. | Clinic/Center | 670 Canton Rd Ne, Suite A, Marietta, GA 30060-8952 | 2011-08-23 |
1194047050 | Cobb Pediatrics, P.C. | Clinic/Center | 410 Villa Rica Way Sw, Marietta, GA 30064-5741 | 2010-02-19 |
1255562757 | Williams Wellness Center | Clinic/Center | 2799 Delk Rd Se, Suite 100, Marietta, GA 30067-6247 | 2009-07-31 |
1871752410 | Pearl Medical & Associates, LLC | Clinic/Center | 2550 Windy Hill Rd Se Ste 109, Marietta, GA 30067-8607 | 2008-06-09 |
1437668548 | Health and Spine Clinic Corp | Clinic/Center | 2475 Windy Hill Rd Se, Marietta, GA 30067-8604 | 2017-09-21 |
1891234118 | Kennestone Family Medicine | Clinic/Center | 72 Plaza Way Nw, Marietta, GA 30060-1104 | 2017-02-20 |
1225410830 | Knowlton Family Practice | Clinic/Center | 1001 Pike St, 7a, Marietta, OH 45750-3515 | 2015-06-19 |
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.