MARIETTA PODIATRY GROUP
NPI 1487638318
Clinic/Center - Podiatric in Marietta, GA
About Marietta Podiatry Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARIETTA PODIATRY GROUP (NPI 1487638318) is a healthcare organization registered as a podiatric in Marietta, Georgia and active in the NPI registry since December 2005. The organization lists Glyn E Lewis, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
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 Podiatry Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Marietta Podiatry Group, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
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 Podiatry Group's NPI number?
The NPI number for Marietta Podiatry Group is 1487638318. It was assigned to this organization in the NPPES registry on December 5, 2005.
Where is Marietta Podiatry Group located?
Marietta Podiatry Group is located at 165 Vann St NE, Marietta, GA 30060. The listed phone number is (770) 422-9856.
What is Marietta Podiatry Group's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Podiatric, with taxonomy code 261QP1100X.
Is Marietta Podiatry Group enrolled in Medicare?
Yes. Marietta Podiatry Group is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Marietta Podiatry Group?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Marietta Podiatry 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. The largest specialties are Podiatry (3) and Physical Therapist in Private Practice (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Marietta Podiatry Group was last updated on January 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Marietta Podiatry Group · NPI 1487638318
Podiatric organization in Marietta, Georgia. Organization record, active in the CMS NPPES registry since December 5, 2005.
## Identity
- **NPI:** 1487638318 (Entity type: Organization)
- **Enumerated:** December 5, 2005
- **Primary specialty:** Clinic/Center - Podiatric · taxonomy 261QP1100X
- **Organization subpart:** No
- **Authorized official:** Glyn Lewis, CEO
## Practice location
- **Address:** 165 VANN ST NE, Marietta, GA 30060-7249
- **Phone:** (770) 422-9856 · **Fax:** (770) 984-0303
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Podiatry (3), Physical Therapist in Private Practice (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 5, 2012
- **Other identifiers:** Medicare NSC 0940220002 (GA)
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Source: [NPI Profile](https://npiprofile.com/npi/1487638318) · Data from the CMS NPPES public registry.