KENNESTONE HEART PHYSICIANS GROUP NPI 1003011776

Internal Medicine (Cardiovascular Disease) in Blue Ridge, GA

NPI 1003011776 Organization Internal Medicine Cardiovascular Disease

About KENNESTONE HEART PHYSICIANS GROUP

Kennestone Heart Physicians Group is an internal medicine provider established in Blue Ridge, Georgia specializing in internal medicine (cardiovascular disease) . The NPI number of Kennestone Heart Physicians Group is 1003011776 and was assigned on June 2007. The practitioner's primary taxonomy code is 207RC0000X with license number 00058204 (GA). The provider is registered as an organization and their NPI record was last updated 12 years ago. Kennestone Heart Physicians Group operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Katie M Doyle (Manager, Physician Services)

An internist like Kennestone Heart Physicians Group is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

NPI

1003011776

Provider NameKENNESTONE HEART PHYSICIANS GROUP
Provider Location Address101 RIVERSTONE VIS SUITE 217 BLUE RIDGE, GA 30513
Provider Mailing Address355 TOWER RD NE SUITE 300 MARIETTA, GA 30060
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date06-20-2007
Last Update Date05-21-2009


Primary Taxonomy

Taxonomy Code207RC0000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationCardiovascular Disease
License No.00058204
License StateGA
Taxonomy DescriptionAn 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.

Business Address

KENNESTONE HEART PHYSICIANS GROUP
101 RIVERSTONE VIS
SUITE 217
BLUE RIDGE, GA
ZIP 30513
Phone: (706) 632-8008
Fax: (706) 632-8070

Get Directions


Mailing Address

KENNESTONE HEART PHYSICIANS GROUP
355 TOWER RD NE
SUITE 300
MARIETTA, GA
ZIP 30060
Phone: (770) 426-4721
Fax: (770) 424-0391



Authorized Official

Authorized Official Name KATIE M DOYLE
Authorized Official TitleMANAGER, PHYSICIAN SERVICES
Authorized Official Phone(678) 797-1113

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
GRP938MEDICARE PIN (08)GA

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1174522262DR. FRANK STANSON TRIGG M.D.
Individual
Internal Medicine101 RIVERSTONE VIS SUITE 203
BLUE RIDGE, GA 30513
(706) 632-8787
1588663686DR. RAYMOND EUGENE TIDMAN MD
Individual
Family Medicine101 RIVERSTONE VIS SUITE 205
BLUE RIDGE, GA 30513
(706) 632-4400
1316947260 LEE ANN TIDMAN CNP
Individual
Nurse Practitioner101 RIVERSTONE VIS SUITE 205
BLUE RIDGE, GA 30513
(706) 632-4400
1881655728 MARILYN A WILLIAMS NP
Individual
Nurse Practitioner101 RIVERSTONE VIS
BLUE RIDGE, GA 30513
(706) 632-4400
1487610945DR. PHILIP R MILLS MD
Individual
Dermatology101 RIVERSTONE VIS SUITE 205
BLUE RIDGE, GA 30513
(706) 632-4100
1861445447 JACQUELINE A. MALLOY ARNP
Individual
Nurse Practitioner (Family)101 RIVERSTONE VIS
BLUE RIDGE, GA 30513
(706) 258-4400
1578593349 ROBERTA YVONNE TOWLE SW
Individual
Social Worker (Clinical)101 RIVERSTONE VIS
BLUE RIDGE, GA 30513
(706) 632-4400
1982636767DR. EDWARD LEE BOYE LPC
Individual
Counselor (Pastoral)101 RIVERSTONE VIS SUITE 201A
BLUE RIDGE, GA 30513
(423) 496-9878
1952496739CARDIAC DISEASE SPECIALISTS, PC
Organization
Internal Medicine (Cardiovascular Disease)101 RIVERSTONE VIS
BLUE RIDGE, GA 30513
(706) 632-8008
1093882805RIVERSTONE IMAGING CENTER
Organization
Clinic/Center (Radiology)101 RIVERSTONE VIS
BLUE RIDGE, GA 30513
(706) 258-4120
1104954106IMMEDIATE MEDCARE OF RIVERSTONE,LLC
Organization
Clinic/Center (Urgent Care)101 RIVERSTONE VIS
BLUE RIDGE, GA 30513
(706) 258-4400
1891810933GEORGIA OXYGEN PHARMACY
Organization
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)101 RIVERSTONE VIS STE 103
BLUE RIDGE, GA 30513
(706) 258-4545
1518130723SLEEP SERVICES OF AMERICA
Organization
Clinical Medical Laboratory101 RIVERSTONE VIS SUITE 205
BLUE RIDGE, GA 30513
(404) 892-0308
1124280011MS. LAURA ELIZABETH PARKER LPC
Individual
Counselor (Professional)101 RIVERSTONE VIS SUITE 201 A
BLUE RIDGE, GA 30513
(770) 235-1059
1245483718 ASHLEY MEGAN JONES
Individual
Physical Therapist101 RIVERSTONE VIS STE. 113
BLUE RIDGE, GA 30513
(706) 964-4261
1538393442 JUDITH MARIE BOIVIN R.N.,LCSW, ACSW
Individual
Social Worker (Clinical)101 RIVERSTONE VIS
BLUE RIDGE, GA 30513
(706) 851-6019
1689954372BLUE RIDGE DERMATOLOGY
Organization
Dermatology101 RIVERSTONE VIS STE 215
BLUE RIDGE, GA 30513
(706) 946-4227
1386929222MARC S BERGER MD PC
Organization
Family Medicine101 RIVERSTONE VIS STE 217
BLUE RIDGE, GA 30513
(706) 946-4240
1629329792NSH CANCER INSTITUTE PROFESSIONAL SERVICES G LLC
Organization
Durable Medical Equipment & Medical Supplies101 RIVERSTONE VIS SUITE 102
BLUE RIDGE, GA 30513
(706) 258-4140
1982698908 JONATHAN A BLOCH MD
Individual
Surgery101 RIVERSTONE VIS SUITE 212
BLUE RIDGE, GA 30513
(706) 946-4253

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.