BRENDA L MARINO (NPI# 1023059581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023059581 |
| Entity Type | Individual |
| Full Name | BRENDA L MARINO |
| Credential | MD |
| Practice Address |
677 Church St Hospital Based Only Kennestone Wellstar Marietta GA 30060 |
| Mailing Address |
Po Box 4214 Marietta GA 30061 |
| Practice Telephone | 7707793603 |
| Practice Fax Number | 7707939925 |
| Mailing Telephone | 7704274800 |
| Mailing Fax Number | 7704273653 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
016392 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00088646B | 05 |
| Street Address |
677 CHURCH ST HOSPITAL BASED ONLY KENNESTONE WELLSTAR |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205874971 | Emma D Casanova | Pediatrics | 677 Church St, Hospital Based Only Kennestone Wellstar, Marietta, GA 30060 | 2006-06-03 |
| 1851746622 | Mariya Zhukova | Obstetrics & Gynecology | 677 Church St, Marietta, GA 30060-1101 | 2016-04-29 |
| 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 | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| 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) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679730501 | Marietta Neonatology, P.C. | Pediatrics | 800 Kennesaw Ave Nw, Suite 200, Marietta, GA 30060-1051 | 2008-05-19 |
| 1205874971 | Emma D Casanova | Pediatrics | 677 Church St, Hospital Based Only Kennestone Wellstar, Marietta, GA 30060 | 2006-06-03 |
| 1073757589 | Amanda Mashae Evans | Pediatrics | 800 Kennesaw Ave Nw, Marietta, GA 30060-1051 | 2009-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356762553 | Edward D Conner Md PC | Pediatrics | 112 Gleneagles Cir, Macon, GA 31210-2943 | 2013-12-16 |
| 1962832444 | Georgia Neonatology LLC | Pediatrics | 124 Bradford Dr, Macon, GA 31210-1267 | 2013-11-19 |
| 1124348826 | Suneeti Gupta | Pediatrics | 5901 Peachtree Dunwoody Rd # C, Suite C 65, Atlanta, GA 30328-5382 | 2010-06-03 |
| 1225266745 | Jack Gibson Gray | Pediatrics | 135 Tamerlane, Peachtree City, GA 30269-2700 | 2009-06-23 |
| 1184851008 | Ima S Thompson | Pediatrics | 550 Medical Center Blvd, Lawrenceville, GA 30046-7688 | 2009-06-18 |
| 1528201027 | Sarita A. Patel | Pediatrics | 5901 Peachtree Dunwoody Rd, Suite B 420, Atlanta, GA 30328-5382 | 2009-04-13 |
| 1598959124 | Danielle Cecelia Giliberti Kallmyer | Pediatrics | 1428 Markan Dr Ne, Atlanta, GA 30306-2305 | 2007-08-27 |
| 1477750818 | Angela Marie Fagiana | Pediatrics | 4750 Waters Ave Ste 206, Savannah, GA 31404-6278 | 2007-06-29 |
| 1710060256 | William Ranson Laforce | Pediatrics | 315 Boulevard Ne Ste 500, Atlanta, GA 30312-1266 | 2006-10-20 |
| 1518047877 | Heidi Eigenrauch Karpen | Pediatrics | Emory Childrens Center Neonatology, 2015 Uppergate Drive Ne, Atlanta, GA 30322-1014 | 2006-10-17 |
| 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.