KENNESTONE HEART PHYSICIANS GROUP (NPI# 1306086228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306086228 |
| Entity Type | Organization |
| Organization Name | KENNESTONE HEART PHYSICIANS GROUP |
| Practice Address |
200 Oakside Ln Suite D Canton GA 30114-6416 |
| Mailing Address |
355 Tower Rd Ne Suite 300 Marietta GA 30060-9408 |
| Practice Telephone | 7704264721 |
| Practice Fax Number | 6788806513 |
| Mailing Telephone | 7704264721 |
| Mailing Fax Number | 7704240391 |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2009-03-05 |
| Authorized Official Name | DR. WM MICHAEL BROWN (PRESIDENT) |
| Authorized Official Telephone | 6787974113 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
2009PROFS-0051 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 300025641K | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699721662 | Kennestone Heart Physicians Group | Internal Medicine | 355 Tower Road, Suite 300, Marietta, GA 30060 | 2006-05-25 |
| 1003011776 | Kennestone Heart Physicians Group | Internal Medicine | 101 Riverstone Vis, Suite 217, Blue Ridge, GA 30513-6648 | 2007-06-20 |
| 1962566042 | Kennestone Heart Physicians Group | Internal Medicine | 120 Stonebridge Pkwy, Suite 440, Woodstock, GA 30189-3767 | 2006-12-21 |
| Street Address |
200 OAKSIDE LN SUITE D |
| City | CANTON |
| State | GA |
| Zip Code | 30114-6416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659374262 | Bradley Robert Peters | Radiology | 200 Oakside Ln, Ste A, Canton, GA 30114-6416 | 2005-05-27 |
| 1457640831 | Canton Specialty Imaging, LLC | Specialist | 200 Oakside Ln, Suite A, Canton, GA 30114-6416 | 2011-04-06 |
| 1588774467 | Teru Kay Lapaquette | Obstetrics & Gynecology | 200 Oakside Ln, Suite D, Canton, GA 30114-6416 | 2006-08-30 |
| 1932155355 | Imaging Associates of Canton | Clinic/Center | 200 Oakside Ln, Suite A, Canton, GA 30114-6415 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982168100 | Optimum Cardiology Inc | Internal Medicine | 4825 Higbee Ave Nw Ste 102, Canton, OH 44718-2567 | 2019-01-23 |
| 1861716508 | Premier Diagnostics PC | Internal Medicine | 48492 Inveraray Rd, Canton, MI 48188 | 2010-03-24 |
| 1477593572 | Daniel Andrew Pietro | Internal Medicine | 19 Hunter Ln, Canton, MA 02021-1731 | 2006-06-07 |
| 1114997822 | Mohamad Hikmat Kabbani | Internal Medicine | 2050 N Haggerty Rd Ste 200, Canton, MI 48187-3796 | 2006-01-25 |
| 1548269756 | David J. Utlak | Internal Medicine | 4455 Dressler Rd Nw, Canton, OH 44718-2769 | 2005-07-19 |
| 1487653986 | Stephen W Pipoly | Internal Medicine | 1330 Mercy Drive Nw, Suite 410, Canton, OH 44708 | 2005-07-18 |
| 1154329928 | Kirk B Laman | Internal Medicine | 15 Reinhardt College Pkwy, Suite 110, Canton, GA 30114-5257 | 2005-07-14 |
| 1205126851 | Anjan Deka | Internal Medicine | 460 Northside Cherokee Blvd Ste 190, Canton, GA 30115-8018 | 2011-04-17 |
| 1184864258 | Kennestone Heart Physicians Group, PC | Internal Medicine | 720 Transit Ave, Building 100, Suite 102, Canton, GA 30114-2540 | 2009-03-02 |
| 1780878447 | Peter Kometiani | Internal Medicine | 2600 Sixth St Sw Ste 710, Canton, OH 44710-1702 | 2007-09-05 |
| Find all providers in CANTON | ||||
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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.