PREMIER PODIATRY-EAST COBB (NPI# 1396000279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396000279 |
Entity Type | Organization |
Organization Name | PREMIER PODIATRY-EAST COBB |
Practice Address |
1121 Johnson Ferry Rd Building 1, Suite 215 Marietta GA 30068-5425 |
Mailing Address |
1200 Johnson Ferry Rd Ste 150 Marietta GA 30068-5403 |
Practice Telephone | 7706930700 |
Mailing Telephone | 7706930700 |
Mailing Fax Number | 7709719822 |
Enumeration Date | 2012-07-07 |
Last Update Date | 2018-03-02 |
Authorized Official Name | DR. TREVOR R BEACH (PHYSICIAN/OWNER) |
Authorized Official Telephone | 7709719820 |
Authorized Official Credential | DPM |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
GA | Podiatric Medicine & Surgery Service Providers | |
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
Street Address |
1121 JOHNSON FERRY RD BUILDING 1, SUITE 215 |
City | MARIETTA |
State | GA |
Zip Code | 30068-5425 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932195013 | Susan Stephen Glander | Obstetrics & Gynecology | 1121 Johnson Ferry Rd, Suite 150, Marietta, GA 30068-5425 | 2005-09-23 |
1801224167 | Roquin Pain Center | Clinic/Center | 1121 Johnson Ferry Rd, Suite 340, Marietta, GA 30068-5425 | 2013-10-24 |
1255776134 | Optimal Health Care, LLC | Internal Medicine | 1121 Johnson Ferry Rd, Suite 205, Marietta, GA 30068-5425 | 2013-05-06 |
1215270368 | Julie C Tanner | Dentist | 1121 Johnson Ferry Rd, Suite 450, Marietta, GA 30068-5425 | 2013-03-27 |
1447541206 | Stephen Mitchell Martin | Emergency Medicine | 1121 Johnson Ferry Rd, Suite 100, Marietta, GA 30068-5425 | 2011-04-28 |
1477866234 | Vanessa D Dunn | Nurse Practitioner | 1121 Johnson Ferry Rd, Suite 100, Marietta, GA 30068-5425 | 2010-07-22 |
1376798272 | Jennifer Louise Billingsley | Dental Assistant | 1121 Johnson Ferry Rd, Suite 320, Marietta, GA 30068-5425 | 2008-11-20 |
1093981227 | Deanna M Fetsch | Nurse Practitioner | 1121 Johnson Ferry Rd, Suite 220, Marietta, GA 30068-5425 | 2008-05-07 |
1821264516 | Sharon Lebedin | Nurse Practitioner | 1121 Johnson Ferry Rd, Suite 220, Marietta, GA 30068-5425 | 2008-05-02 |
1750557435 | Barbara Cossman | Nurse Practitioner | 1121 Johnson Ferry Rd, Suite 220, Marietta, GA 30068-5425 | 2008-05-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831798917 | Barbara Ann Goldschmidt | Pharmacist | 4088 Lower Roswell Rd, Marietta, GA 30068 | 2020-10-20 |
1285274480 | Cory Plasker | Chiropractor | 519b Johnson Ferry Road, Suite 350, Marietta, GA 30068 | 2020-01-15 |
1952949893 | Dr Amy L Varner LLC | Internal Medicine | 1000 Johnson Ferry Rd Bldg E Ste 200, Marietta, GA 30068 | 2019-12-11 |
1417501834 | Cornerstone Hospice and Palliative Care of Georgia, LLC | Hospice Care, Community Based | 1225 Johnson Ferry Rd., Bldg. 100, Suite 160, Marietta, GA 30068 | 2019-07-25 |
1639721038 | Cayla Clark | Behavior Technician | 137 Johnson Ferry Road Suite 2170, Marietta, GA 30068 | 2019-07-15 |
1467910828 | 2me Healthcare,llc | Home Health | 2586 Club Valley Drive Ne, Marietta, GA 30068 | 2019-03-05 |
1265912604 | Feidy Chiropractic Clinic Inc, Dba Cardwell Chiropractic Clinic | Chiropractor | 1230 Johnson Ferry Pl Ste G30, Marietta, GA 30068 | 2018-08-15 |
1225514219 | Audrey Hughes. Lcsw, LLC | Clinic/Center | 1212 Johnson Ferry Rd, Suite 300, Marietta, GA 30068 | 2018-07-13 |
1316461379 | Evan King | Registered Nurse | 52 Pioneer Trl, Marietta, GA 30068 | 2017-08-01 |
1912431867 | Anthony Izore | Nurse Practitioner | 5163 Tall Oak Drive, Marietta, GA 30068 | 2017-04-18 |
Find all providers in zip 30068 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194184879 | Sequioa Ducasse | Podiatrist | 2550 Windy Hill Rd Se Ste 206, Marietta, GA 30067-8654 | 2016-02-23 |
1578946745 | Neha Delvadia | Podiatrist | 3901 Roswell Rd Ste 340, Marietta, GA 30062-6250 | 2015-07-06 |
1447653761 | Marie-christine Bergeron | Podiatrist | 3225 Shallowford Rd Ste 200, Marietta, GA 30062-1288 | 2014-10-01 |
1578856902 | Irene Cristina Verlezza | Podiatrist | 1200 Johnson Ferry Rd Ste 150, Marietta, GA 30068-5403 | 2011-05-18 |
1811019730 | Vivian Chizorom Iwu | Podiatrist | 540 Powder Springs St Ste B6, Marietta, GA 30064-3559 | 2007-04-03 |
1700981057 | Nathan Harold Schwartz | Podiatrist | 792 Church St Ne Ste 102, Marietta, GA 30060 | 2006-09-13 |
1497740229 | Mathew M. John | Podiatrist | 2790 Sandy Plains Rd, Suite 300, Marietta, GA 30066-4378 | 2005-09-19 |
1427055805 | Mark R. Light | Podiatrist | 4439 Roswell Rd, Marietta, GA 30062-6452 | 2005-06-30 |
1043827280 | Choice Podiatry Center, Inc. | Podiatrist | 540 Powder Springs St Ste B6, Marietta, GA 30064-3559 | 2020-09-30 |
1730721408 | Krishna Podiatry Group of Georgia | Podiatrist | 3901 Roswell Rd Ste 340, Marietta, GA 30062-6250 | 2019-10-14 |
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.