DR. MARYANN KURUVILLA JACOB (NPI# 1356375315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356375315 |
| Entity Type | Individual |
| Full Name | DR. MARYANN KURUVILLA JACOB |
| Credential | M.D. |
| Practice Address |
1256 Briarcliff Rd Ne Rm 321 Atlanta GA 30306-2636 |
| Mailing Address |
963 Ponce De Leon Ave Ne Apt 301 Atlanta GA 30306-4254 |
| Practice Telephone | 4047273903 |
| Mailing Telephone | 2488855692 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
058562 | GA | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
4301086452 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649665670 | Maryann Prakash Jacob | General Practice | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2015-04-06 |
| Street Address |
1256 BRIARCLIFF RD NE RM 321 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30306-2636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750900858 | Jill Driver | Chiropractor | 1390 Lanier Blvd Ne, 1409-a, Atlanta, GA 30306 | 2020-04-09 |
| 1447737697 | Heather Nicole Vansau | Speech-Language Pathologist | 1272 Stillwood Dr Ne, Atlanta, GA 30306 | 2018-07-20 |
| 1871095919 | Michelle Ruth Orovitz | Nurse Practitioner | 1140 Briarcliff Rd Ne Apt 1, Atlanta, GA 30306 | 2018-03-05 |
| 1497261960 | Rockwell Oral and Facial Surgery LLC | Dentist | 675 N. Highland Ave Ne, Suite 100, Atlanta, GA 30306 | 2017-12-20 |
| 1518414101 | David Alan Sturgess Jr. | Counselor | 696 Courtenay Dr, Ne, Atlanta, GA 30306 | 2016-09-01 |
| 1952778565 | Kristen Jugs | Speech-Language Pathologist | 609 Virginia Ave Ne Apt 4108, None, Atlanta, GA 30306 | 2015-08-31 |
| 1962749655 | Robert B Tersak | Pharmacist | 1001 Ponce De Leon Avenue Ne, Atlanta, GA 30306 | 2013-01-15 |
| 1730434812 | Poonam Bhakta Hurley | Physical Therapist | 842 N Highland Ave Ne Ste Ter, Atlanta, GA 30306 | 2012-07-16 |
| 1609158963 | Centers for Disease Control and Prevention, Us Public Health Service | Public Health or Welfare | 1600 Clifton Rd, Ms E46, Atlanta, GA 30306 | 2011-09-13 |
| 1598045965 | April Kooy | Physician Assistant | 1000 Briarcliff Road Ne, Atlanta, GA 30306 | 2011-08-17 |
| Find all providers in zip 30306 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265064364 | Haven Psychiatry, LLC | Psychiatry & Neurology | 5871 Glenridge Dr Ste 220, Atlanta, GA 30328-5305 | 2020-02-06 |
| 1619309309 | Howel William Slaughter Jr. | Psychiatry & Neurology | 40 Abington Ct Nw, Atlanta, GA 30327-1352 | 2013-08-05 |
| 1427493568 | Susan Kirsch | Psychiatry & Neurology | 7000 Peachtree Dunwoody Rd Bldg 16, Atlanta, GA 30328-1655 | 2013-05-02 |
| 1548550429 | Bene' Mental Wellness | Psychiatry & Neurology | 1835 Savoy Dr Ste 101, Atlanta, GA 30341-1073 | 2011-04-13 |
| 1710280011 | Adam F Silberman | Psychiatry & Neurology | 690 Courtenay Dr Ne, Atlanta, GA 30306-3421 | 2010-12-08 |
| 1497908834 | David Mark Battista | Psychiatry & Neurology | 3149 E Shadowlawn Ave Ne, Atlanta, GA 30305-2405 | 2008-10-29 |
| 1548481005 | Nina Brazell Bass | Psychiatry & Neurology | 2967 Grandview Avenue, Atlanta, GA 30305 | 2007-05-01 |
| 1285752196 | Charlesetta Shelton Scott | Psychiatry & Neurology | 317 Woodward Ave Se, Atlanta, GA 30312-2123 | 2007-03-27 |
| 1497711550 | Kimberly Anne Venable | Psychiatry & Neurology | 1256 Briarcliff Rd Ne, Atlanta, GA 30306-2636 | 2006-04-25 |
| 1447258975 | Michael Warren Bain | Psychiatry & Neurology | 3525 Piedmont Rd Ne, Bldg 6, Suite 210, Atlanta, GA 30305-1578 | 2005-07-08 |
| Find all providers in ATLANTA | ||||
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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.