EAST COBB PODIATRY SURGERY CENTER, LLC (NPI# 1184819930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184819930 |
| Entity Type | Organization |
| Organization Name | EAST COBB PODIATRY SURGERY CENTER, LLC |
| Practice Address |
4439 Roswell Rd Marietta GA 30062-6452 |
| Practice Telephone | 7709778221 |
| Practice Fax Number | 7709778222 |
| Mailing Telephone | 7709778221 |
| Mailing Fax Number | 7709778222 |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2012-06-28 |
| Authorized Official Name | DR. MARK R LIGHT (PHYSICIAN) |
| Authorized Official Telephone | 7709778221 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
11C0001132 | GA | Ambulatory Health Care Facilities |
| Street Address |
4439 ROSWELL RD |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-6452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427055805 | Mark R. Light | Podiatrist | 4439 Roswell Rd, Marietta, GA 30062-6452 | 2005-06-30 |
| 1184770133 | East Cobb Foot & Ankle Care P.C. | Podiatrist | 4439 Roswell Rd, Marietta, GA 30062-6452 | 2007-01-25 |
| 1053470732 | Robert I Heden | Podiatrist | 4439 Roswell Rd, Marietta, GA 30062-6452 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285108845 | Marietta Advanced Surgery Center | Clinic/Center | 1371 Church Street Ext Ne Ste 100, Marietta, GA 30060-7913 | 2019-01-17 |
| 1700369071 | Alliance Surgery Center At Marietta, LLC | Clinic/Center | 400 Tower Rd Ne Ste 375, Marietta, GA 30060-9417 | 2018-09-12 |
| 1952814352 | Medici Surgical Center, LLC | Clinic/Center | 792 Church St Ne Ste 101, Marietta, GA 30060-7291 | 2017-11-08 |
| 1770004772 | Northwest Atlanta Vascular Care LLC | Clinic/Center | 711 Canton Rd Ne Ste 230, Marietta, GA 30060-8949 | 2017-06-29 |
| 1568864452 | Carpus Surgery Center LLC | Clinic/Center | 3775 Roswell Rd, Suite 275, Marietta, GA 30062-8836 | 2014-09-23 |
| 1881001758 | Asuch Surgery Center | Clinic/Center | 2285 Asquith Ave Sw, Suite 100, Marietta, GA 30008-6008 | 2014-07-12 |
| 1235559378 | Skin Cancer Specialists Surgery Center, LLC | Clinic/Center | 835 Cogburn Ave Nw, Suite 200, Marietta, GA 30060-1031 | 2014-04-16 |
| 1801224167 | Roquin Pain Center | Clinic/Center | 1121 Johnson Ferry Rd, Suite 340, Marietta, GA 30068-5425 | 2013-10-24 |
| 1750629325 | Premier Ambulatory Surgical Center, LLC | Clinic/Center | 211 Chicopee Dr Ne, Marietta, GA 30060-1269 | 2013-01-16 |
| 1639499627 | Georgia Urology, Pa | Clinic/Center | 790 Church St Ne, Suite 430, Marietta, GA 30060-7282 | 2010-06-02 |
| 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.