Individual provider Active NPI

Cole Burgess, CRNA

  • Certified Registered Nurse Anesthetist
  • Tifton, GA
National Provider Identifier
1003198268
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN192175 Issued in GA
Practice address
901 18TH St E
Tifton, GA 31794-3648
Phone
(229) 353-6124
Fax
(229) 353-7722
NPI assigned
Sep 14, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valdosta Anesthesia Associates, P.C. 42 clinicians

Practice addresses (Care Compare)

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 244-6852

Hospital & facility affiliations

  • SGMC Health Hospital, Valdosta, GA, CCN 110122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20121128000047 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850542747 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN192175GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Valdosta Anesthesia Associates, P.C. CurrentSince Jul 1, 2015 Accepting new patients
Sweet Dreams Nurse Anesthesia, Inc. Nurse Anesthetist, Certified Registered CurrentSince Sep 11, 2013 Accepting new patients
Nmda Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 20, 2012 Accepting new patients
Sweet Dreams Anesthesiology Nurses of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 21, 2013 Accepting new patients
Synergy Anesthesiology Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 8, 2014 Accepting new patients
Sweet Dreams Nurse Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 30, 2013 Accepting new patients

Locations

158 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-1008

4660 Riverside Park Blvd
Macon, GA 31210
Phone (478) 471-6300

1035 Southcrest Dr
Ste 250
Stockbridge, GA 30281
Phone (770) 996-9945

117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725

3024 N Patterson St
Valdosta, GA 31602
Phone (229) 247-4114

2310 N Patterson St
Bldg C
Valdosta, GA 31602
Phone (229) 244-6852

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN192175 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

901 18TH St E
Tifton, GA 31794-3648

Mailing address

901 18TH St E
Tifton, GA 31794-3648
Phone (229) 353-6124

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
RN192175OtherGALICENSE NUMBER

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 14, 2011.

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1003198268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "229-353-6124",
            "fax_number": "229-353-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "229-353-6124",
            "fax_number": "229-353-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "COLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN192175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "RN192175",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.