MARIETTA PODIATRY GROUP – Podiatric Clinic/Center, NPI 1487638318

MARIETTA PODIATRY GROUP is a healthcare provider. based in Marietta, Georgia. specializing in Podiatric Clinic/Center. The NPI Number for MARIETTA PODIATRY GROUP is 1487638318

Main info

Organization
Name
MARIETTA PODIATRY GROUP
NPI
1487638318
Phone
(770) 422-9856
Address
165 VANN ST NE
Authorized Official
DR. GLYN E LEWIS CEO DPM
Enumeration Date
5 December 2005
Last Update Date
5 January 2012
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for MARIETTA PODIATRY GROUP

  • 165, Vann Street Northeast, Elizabeth, Marietta, Cobb County, Georgia, 30060, United States

    MARIETTA, GA 300607249

    Phone: (770) 422-9856

    Fax: (770) 984-0303

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Revalidation scheduled

Earliest CMS due date is 2026-09-30 (107 days away).

Enrollment records

1

Earliest due date

2026-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930053160OPhysician - PodiatryGA2026-09-30

What to do next

  • Monitor the published due date as it approaches.
  • Plan to revalidate in PECOS within the window CMS allows before the due date.
  • Verify the date on the CMS Revalidation Lookup Tool before submitting.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30060)

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Reviews

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Frequently asked questions

What is the registry number for MARIETTA PODIATRY GROUP?
The registry entry for MARIETTA PODIATRY GROUP shows NPI 1487638318.
Is MARIETTA PODIATRY GROUP currently accepting referrals based on NPI status?
Registry metadata lists MARIETTA PODIATRY GROUP as active.
Which specialty label fits MARIETTA PODIATRY GROUP?
NPPES ties MARIETTA PODIATRY GROUP to Podiatric Clinic/Center in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit MARIETTA PODIATRY GROUP in Marietta, Georgia?
For routing, start with Marietta, Georgia for MARIETTA PODIATRY GROUP, then verify phone and hours locally.
Who maintains MARIETTA PODIATRY GROUP's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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