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MARIETTA MEDICAL GROUP
NPI 1366497398
Clinic/Center - Primary Care in Marietta, GA

Active since May 25, 2006
741 CHANCE RD, MARIETTA, GA 30066(770) 977-5355(770) 973-8497 Get Directions Write a Review

NPPES record last updated: August 10, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Marietta Medical Group NPPES

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

MARIETTA MEDICAL GROUP (NPI 1366497398) is a healthcare organization registered as a primary care in Marietta, Georgia and active in the NPI registry since May 2006. The organization lists Imani D. Vannoy, Doctor, as its authorized official.

NPPES Registry Identity

NPI1366497398
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMARIETTA MEDICAL GROUP
Location Address741 CHANCE RDMarietta, GA 30066-3711
Mailing Address741 Chance RdMarietta, GA 30066-3711 · (770) 977-5355 · Fax (770) 973-8497
Phone(770) 977-5355
Fax(770) 973-8497
Organization SubpartNo
Authorized OfficialImani D. VannoyDoctor · (770) 977-5355
Enumeration DateMay 25, 2006
Last NPPES UpdateAugust 10, 2009
✔ NPI 1366497398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in GA · 024225
741 CHANCE RD, Marietta, GA 30066
Open in Google Maps ↗

Other Identifiers 3

Medicaid000356617AGA
Medicare PIN11SCGDHGA
Medicare UPIND41281GA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marietta Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Marietta Medical Group, which bills Medicare for the services this clinician delivers.

Clinician (1)

Imani Vannoy, M.D.
Internal Medicine
NPI 1376596783
741 CHANCE RD
Marietta, GA 30066
(770) 977-5355
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Medical Group's NPI number?

The NPI number for Marietta Medical Group is 1366497398. It was assigned to this organization in the NPPES registry on May 25, 2006.

Where is Marietta Medical Group located?

Marietta Medical Group is located at 741 Chance Rd, Marietta, GA 30066. The listed phone number is (770) 977-5355.

What is Marietta Medical Group's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Marietta Medical Group enrolled in Medicare?

Yes. Marietta Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Marietta Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Marietta Medical Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Marietta Medical Group accept?

Health plans from Ambetter Health list Marietta Medical Group as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Marietta Medical Group was last updated on August 10, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.