ROBERTO A. LARRIVEY (NPI# 1720083702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720083702 |
| Entity Type | Individual |
| Full Name | ROBERTO A. LARRIVEY |
| Credential | MD |
| Practice Address |
790 Church St Ne Ste 140 Marietta GA 30060-8902 |
| Mailing Address |
5555 Peachtree Dunwoody Rd Ne Ste 125 Atlanta GA 30342-1703 |
| Practice Telephone | 7704257199 |
| Practice Fax Number | 6788195538 |
| Mailing Telephone | 4042552918 |
| Mailing Fax Number | 4042555837 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2009-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 052983 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 956323850B | 05 | |
| GA | 956323850A | 05 |
| Street Address |
790 CHURCH ST NE STE 140 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-8902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003356361 | Proactive Physicians of Marietta, PC | Clinic/Center | 790 Church St Ne, Suite 220, Marietta, GA 30060-7282 | 2017-03-06 |
| 1720535529 | Tracy Zoblisein | Pharmacist | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2016-09-09 |
| 1609323641 | Lisa Long | Pharmacist | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2016-09-07 |
| 1306293113 | Kristina L Thomas | Nurse Practitioner | 790 Church St Ne, Suite 150, Marietta, GA 30060-7282 | 2016-05-21 |
| 1447681218 | James Wesley Garrett | Physician Assistant | 790 Church St Ne, Ste 400, Marietta, GA 30060-7282 | 2013-12-04 |
| 1396083606 | Deborah Luann Hurd | Nurse Practitioner | 790 Church St Ne, Suite 330, Marietta, GA 30060-7282 | 2013-01-21 |
| 1336485457 | Paradigm Medical LLC | Specialist | 790 Church St Ne, Suite 410, Marietta, GA 30060-7282 | 2012-12-18 |
| 1679824742 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2012-09-28 |
| 1568724052 | Brandon M Paritz | Family Medicine | 790 Church St Ne, Suite 250, Marietta, GA 30060-7282 | 2012-06-12 |
| 1073870093 | Physicians Spine & Rehabilitation Specialists of Georgiapc | Pain Medicine | 790 Church St Ne, Suite 550, Marietta, GA 30060-7282 | 2012-04-16 |
| Find all providers in the same location | ||||
| 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 | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417103557 | David Michael Weeks | Otolaryngology | 699 Church St, Ste 340, Marietta, GA 30060 | 2008-08-08 |
| 1619933249 | Seth A Yellin | Otolaryngology | 111 Marble Mill Rd Nw, Marietta, GA 30060-1047 | 2006-04-22 |
| 1538145263 | Richard Alan Gunovich | Otolaryngology | 800 Wayne St Ste 112, Marietta, OH 45750-3309 | 2005-12-15 |
| 1518958552 | David Parks | Otolaryngology | 699 Church St Ne Ste 340, Marietta, GA 30060 | 2005-10-31 |
| 1912996422 | Lawrence Steven Weiss | Otolaryngology | 3901 Roswell Rd, Ste 225, Marietta, GA 30062-8816 | 2005-10-18 |
| 1093717688 | Andrew Everett Sutton | Otolaryngology | 780 Canton Rd Ne, Suite 330, Marietta, GA 30060-7241 | 2005-08-12 |
| 1790786911 | Drew Matthew Locandro | Otolaryngology | 80 Lacy St Nw, Northwest Ent and Allergy Center, Marietta, GA 30060 | 2005-08-10 |
| 1629075833 | Donald W Alexander | Otolaryngology | 833 Campbell Hill Street, Suite 420, Marietta, GA 30060-1138 | 2005-07-01 |
| 1780688051 | Patrick Melder | Otolaryngology | 699 Church St Ne, Ste 340, Marietta, GA 30060 | 2005-06-02 |
| 1053707042 | Nicholas Mildenhall | Otolaryngology | 699 Church St Ne Ste 340, Marietta, GA 30060-1131 | 2015-04-07 |
| 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.