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MARIETTA PLASTIC SURGERY
NPI 1164746244
Surgery - Plastic and Reconstructive Surgery in Woodstock, GA

Active since March 18, 2010CLIA 11D0954036 · Waiver
149 TOWNE LAKE PKWY, WOODSTOCK, GA 30188(678) 494-2380(678) 494-2379 Get Directions Write a Review

NPPES record last updated: March 18, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Marietta Plastic Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIETTA PLASTIC SURGERY (NPI 1164746244) is a healthcare organization registered as a plastic and reconstructive surgery in Woodstock, Georgia and active in the NPI registry since March 2010. The organization holds a CLIA Waiver certificate valid through April 2, 2027 and lists Donna Marie Bockhorst, Practice Admin, as its authorized official.

NPPES Registry Identity

NPI1164746244
Entity TypeOrganization
Primary Taxonomy2086S0122X
Legal Business NameMARIETTA PLASTIC SURGERY
Location Address149 TOWNE LAKE PKWYWoodstock, GA 30188-4859
Mailing Address149 Towne Lake PkwyWoodstock, GA 30188-4859 · (678) 494-2380 · Fax (678) 494-2379
Phone(678) 494-2380
Fax(678) 494-2379
Organization SubpartNo
Authorized OfficialDonna Marie BockhorstPractice Admin · (770) 425-0118
Enumeration DateMarch 18, 2010
✔ NPI 1164746244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
Definition

A surgeon who specializes in plastic and reconstructive surgery.

149 TOWNE LAKE PKWY, Woodstock, GA 30188
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Other Identifiers 1

Medicare PINGRP 626GA

Group Practice 1

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D0954036

Marietta Plastic Surgery PC · Marietta, GA
Active · expires Apr 2, 2027
CLIA Number11D0954036
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateApril 3, 2025
Certificate Expiration DateApril 2, 2027
Laboratory DirectorNancy Townsend
Laboratory Phone(770) 425-0118
Laboratory LocationMarietta Plastic Surgery PC823 Campbell Hill St, Marietta, GA 30060
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marietta Plastic Surgery's NPI number?

The NPI number for Marietta Plastic Surgery is 1164746244. It was assigned to this organization in the NPPES registry on March 18, 2010.

Where is Marietta Plastic Surgery located?

Marietta Plastic Surgery is located at 149 Towne Lake Pkwy, Woodstock, GA 30188. The listed phone number is (678) 494-2380.

What is Marietta Plastic Surgery's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Does Marietta Plastic Surgery hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0954036) is associated with this NPI, valid through April 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Marietta Plastic Surgery was last updated on March 18, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.