GOOD SAMARITAN HEALTH CENTER OF COBB (NPI# 1881923126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881923126 |
| Entity Type | Organization |
| Organization Name | GOOD SAMARITAN HEALTH CENTER OF COBB |
| Practice Address |
1605 Roberta Dr Sw Marietta GA 30008-3855 |
| Practice Telephone | 4049373850 |
| Practice Fax Number | 7704193121 |
| Mailing Telephone | 7704193120 |
| Mailing Fax Number | 7704193121 |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2018-03-28 |
| Authorized Official Name | MRS. ERIN HIERS (OPERATING COORDINATOR) |
| Authorized Official Telephone | 4049373850 |
| Authorized Official Credential | MPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251V00000X | Voluntary or Charitable | 054389 | GA | Agencies |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 01000654 | 05 | |
| GA | 003151808A | 05 | |
| MEDICARE PART B | 202G703251 | 01 | |
| GA | MEDICARE PART A PTAN | 111043 | 01 |
| GA | MEDICARE | 08BBRXN | 01 |
| Street Address |
1605 ROBERTA DR SW |
| City | MARIETTA |
| State | GA |
| Zip Code | 30008-3855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710063680 | Peter Wyman | Internal Medicine | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2006-10-31 |
| 1255984324 | Ji Won Park | Dentist | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2019-07-18 |
| 1275015281 | Venetta Diale Belowe Mwengella | Nurse Practitioner | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2018-09-06 |
| 1922503572 | Patricia Guzman | Dental Hygienist | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2018-03-27 |
| 1912458456 | Joel Philip Carpenter | Family Medicine | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2016-10-19 |
| 1578819918 | Laura L. Bayani | Physician Assistant | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2012-08-02 |
| 1659650331 | Alan B Kirk | Social Worker | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2011-08-11 |
| 1326349614 | Marjan Zarif Kirkland | Nurse Practitioner | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2010-11-03 |
| 1669609442 | Dolly Penn White | Preventive Medicine | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2009-06-18 |
| 1740454875 | Adrienne Nicole Polite | Family Medicine | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2008-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952740276 | Beta Discount Pharmacy & Health Services, LLC | Pharmacy | 776 Sandtown Rd Sw, Marietta, GA 30008 | 2013-06-19 |
| 1982935607 | Family Home Care, LLC | Respite Care | 1791 Silver Leaf Ct, Marietta, GA 30008 | 2010-01-20 |
| 1952546533 | Daniel Park | Plastic Surgery | 2285 Asquith Ave Sw Ste 200, Marietta, GA 30008 | 2008-12-10 |
| 1265657399 | Scott D Warner | Chiropractor | 3201 Austell Rd Sw, Marietta, GA 30008 | 2007-04-16 |
| 1972572642 | Cobb County Board of Health | Public Health or Welfare | 1650 County Services Parkway, Marietta, GA 30008 | 2006-03-15 |
| 1538662622 | Lorna Brown | Nurse Practitioner | 1825 County Services Pkwy Sw, Marietta, GA 30008 | 2018-03-14 |
| 1760825905 | Avantika Varma | Family Medicine | 1650 County Services Pkwy Sw Ste 200, Marietta, GA 30008 | 2013-04-08 |
| 1689887663 | Brenda W Wilson | Psychiatry & Neurology | 1650 County Services Pkwy, Marietta, GA 30008 | 2007-05-07 |
| 1043423023 | Karen J Carter | Psychiatry & Neurology | 1650 County Services Pkwy, Marietta, GA 30008 | 2007-05-07 |
| 1043587330 | Francine Edwards | Speech-Language Pathologist | 3665 Austell Road Sw, Suite 1017, Marietta, GA 30008-0000 | 2011-11-30 |
| Find all providers in zip 30008 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023658523 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1407 Cobb Parkway Nw, Marietta, GA 30060-6546 | 2020-01-13 |
| 1497079677 | The Family Health Centers of Georgia, Inc | Clinic/Center | 1650 County Services Pkwy Sw, Marietta, GA 30008-4010 | 2010-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1366066243 | Health Education Assessment and Leadership Inc | Clinic/Center | 225 Griffin St Nw, Atlanta, GA 30314-3917 | 2020-06-05 |
| 1851924377 | Valley Healthcare System | Clinic/Center | 1458 Benning Dr, Columbus, GA 31903-2200 | 2020-02-13 |
| 1952941528 | Curtis V. Cooper Primary Health Care, Inc | Clinic/Center | 400 E Broad St, Savannah, GA 31401-5104 | 2020-01-13 |
| 1467092221 | Careconnect Health, Inc. | Clinic/Center | 130 N Lee St, Forsyth, GA 31029-2122 | 2020-01-09 |
| 1417597238 | The Family Health Centers of Georgia, Inc | Clinic/Center | 19 John Maddox Dr Nw Ste B, Rome, GA 30165-1477 | 2020-01-09 |
| 1649810714 | Careconnect Health, Inc. | Clinic/Center | 254 Wright Avenue, Roberta, GA 31078 | 2020-01-07 |
| 1437798725 | Careconnect Health, Inc. | Clinic/Center | 414 S Frontage Rd Lot 53, Forsyth, GA 31029-3025 | 2020-01-03 |
| 1285277608 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1976 Flat Shoals Rd Se Ste B, Atlanta, GA 30316-2857 | 2019-10-18 |
| 1467094649 | South Central Primary Care Center, Inc | Clinic/Center | 149 Chieftain Cir, Ocilla, GA 31774-2231 | 2019-10-09 |
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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.