CHILDREN'S CARRDIOVASCULAR MEDICINE P.C (NPI# 1003934480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003934480 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S CARRDIOVASCULAR MEDICINE P.C |
| Practice Address |
61 Whitcher St Ne Marietta GA 30060-1176 |
| Practice Telephone | 4049430289 |
| Practice Fax Number | 4049439787 |
| Mailing Telephone | 4049430289 |
| Mailing Fax Number | 4049439787 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. EDUARDO MONTANA JR. (EXECUTIVE MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4049430289 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians |
| Street Address |
61 WHITCHER ST NE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-1176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124014568 | Richard W Cohen | Orthopaedic Surgery | 61 Whitcher St Ne, Suite 1100, Marietta, GA 30060-1176 | 2005-09-21 |
| 1376050955 | Gina M Soto | Nurse Practitioner | 61 Whitcher St Ne, Marietta, GA 30060-1176 | 2018-01-04 |
| 1477062594 | Anna Swanson Bouchard | Nurse Practitioner | 61 Whitcher St Ne, Marietta, GA 30060-1176 | 2017-09-20 |
| 1396281200 | Trevor J Wallace | Physician Assistant | 61 Whitcher St Ne, Suite 1100, Marietta, GA 30060-1176 | 2017-01-17 |
| 1720537327 | Taylor Dellinger | Nurse Practitioner | 61 Whitcher St Ne, Suite 3110, Marietta, GA 30060-1176 | 2016-09-25 |
| 1164871117 | Georgiana Massad | Physician Assistant | 61 Whitcher St Ne, Suite 2100, Marietta, GA 30060-1176 | 2016-06-10 |
| 1134593809 | Sarah Applegarth | Physician Assistant | 61 Whitcher St Ne, Suite 2100, Marietta, GA 30060-1176 | 2015-11-18 |
| 1336543529 | Wellstar Medical Group, LLC | Internal Medicine | 61 Whitcher St Ne, Suite 4100b, Marietta, GA 30060-1181 | 2014-10-16 |
| 1346660198 | Catherine Chmiel | Nurse Practitioner | 61 Whitcher St Ne, Suite 4100, Marietta, GA 30060-1176 | 2014-04-20 |
| 1467885863 | Wellstar Medical Group, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 61 Whitcher St Ne, Suite 4100, Marietta, GA 30060-1176 | 2013-08-21 |
| 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 | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528017258 | William T Mahle | Pediatrics | 355 Tower Rd Ne Ste 204, Marietta, GA 30060-9413 | 2006-05-09 |
| 1174554588 | Eduardo Montana Jr. | Pediatrics | 61 Whitcher St, Ste 4140, Marietta, GA 30060 | 2006-07-05 |
| 1104861699 | Cyrus Samai | Pediatrics | 355 Tower Rd Ne, Ste 204, Marietta, GA 30060-9408 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679013452 | Baptist Specialty Physicians Inc | Pediatrics | 3301 N Oak St Ext, Valdosta, GA 31605 | 2017-02-28 |
| 1720408800 | Andrew Porter | Pediatrics | 202 Village Center Pkwy, Stockbridge, GA 30281-9044 | 2014-04-16 |
| 1689606782 | Albert Tuboku-metzger | Pediatrics | 202 Village Center Parkway, Stockbridge, GA 30281 | 2006-07-07 |
| 1992746929 | Deepti Singh | Pediatrics | 2069 Teron Trce, Suite 300, Dacula, GA 30019-1665 | 2006-06-09 |
| 1770521197 | Margaret J Strieper | Pediatrics | 1700 Tree Lane, Ste 330, Snellville, GA 30078 | 2006-06-04 |
| 1679523435 | Michael E Mcconnell | Pediatrics | 202 Village Ctr Parkway, Stockbridge, GA 30281 | 2006-05-11 |
| 1366491953 | Derek A Fyfe | Pediatrics | 1405 Clifton Rd, Atlanta, GA 30322 | 2006-05-09 |
| 1548232036 | Lazaros K Kochilas | Pediatrics | 2835 Brandywine Road, Suite 300, Atlanta, GA 30341-5540 | 2006-02-07 |
| 1861485914 | Georgia Pediatric Cardiology | Pediatrics | 1045 Southcrest Dr, Ste 220, Stockbridge, GA 30281-6113 | 2005-08-24 |
| 1245223304 | David W Jones | Pediatrics | 1045 South Crest Drive, Ste 220, Stockbridge, GA 30281-6113 | 2005-08-24 |
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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.