Dr. Glen Joseph Iannucci
M.D. | Pediatric Cardiology | Male
Dr. Glen Joseph Iannucci, M.D. is a Alpharetta, Georgia based Pediatric doctor with medical specialization in
Pediatric Cardiology.
Current practice location of Dr. Glen Joseph Iannucci is
3300 Old Milton Pkwy Ste 100, Alpharetta, Georgia - 30005-2425. He can be contacted on phone at
404-256-2593 and fax number 770-488-9408.
Dr. Glen Joseph Iannucci is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Glen Joseph Iannucci is
1972787760 which was assigned by NPPES on 28 Dec, 2007 and it was last updated on 22 Jan, 2021.
Dr. Glen Joseph Iannucci license number is
064569 for Pediatrics Pediatric Cardiology (2080P0202X) in Georgia.
Dr. Glen Joseph Iannucci provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Complete Profile:
Dr. Glen Joseph Iannucci basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Cardiology |
|---|
| Provider Name : | Dr. Glen Joseph Iannucci |
|---|
| Credential : | M.D. |
|---|
| Gender : | Male |
|---|
Business Address:
Dr. Glen Joseph Iannucci address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 3300 Old Milton Pkwy Ste 100
Alpharetta, GA, 30005-2425
United States |
|---|
| Phone Number : | 404-256-2593 |
|---|
| Fax Number : | 770-488-9408 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1972787760 |
|---|
| NPI Entity Type : | Individual |
|---|
| First Enrolment Date : | 28 Dec, 2007 |
|---|
| Last Updated On : | 22 Jan, 2021 |
|---|
Medicare Participation:
Dr. Glen Joseph Iannucci participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 8022259761 |
|---|
| Medicare Enrollment ID : | I20130723000782 |
|---|
| Primary Specialty : | Cardiovascular Disease (cardiology) |
|---|
| Medical School : | Medical College Of Georgia School Of Medicine |
|---|
| Graduation Year : | 2007 |
|---|
| Accepts Medicare? | May accept. Dr. Glen Joseph Iannucci may accepts medicare insurance. |
|---|
Group Practice Association:
Dr. Glen Joseph Iannucci is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Dr. Glen Joseph Iannucci is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
|---|
| Children's Healthcare Of Atlanta Cardiology Inc | 6901888395 | 25 | 200 S Enota Dr Ne
Suite 400
Gainesville, GA - 305013474
Ph: 4042562593 | May accept |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Glen Joseph Iannucci are as mentioned. Primary taxonomy code for Dr. Glen Joseph Iannucci, M.D. is
2080P0202X (Pediatrics Pediatric Cardiology).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | 002845 | GA |
| 2080P0202X | Pediatrics Pediatric Cardiology | Yes | 064569 | GA |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Glen Joseph Iannucci such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 003100495C | MEDICAID | GA | |
| 002845 | Other | GA | RESTRAINING PERMIT # |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | sibley@choa.gadirect.com
Sibley | | HIE
Health Information Exchange (HIE)
| OTHER
Other
PHI | 3300 OLD MILTON PKWY STE 100,
ALPHARETTA, GA, 30005-2425
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 2835 Brandywine Rd, Suite 300
Atlanta, GA, 30341-5510
United States |
|---|
| Phone Number : | 404-256-2593 |
|---|
| Fax Number : | 770-488-9408 |
|---|
Business Location:
Patients can refer following map for directions to
Dr. Glen Joseph Iannucci practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.