NPIMap

Organization Active NPI

Lake Lanier Anesthesia Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Gainesville, GA
National Provider Identifier
1003443722
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
LAKE LANIER ANESTHESIA ASSOCIATES, LLC
Practice address
2324 Limestone Overlook Ste 200
Gainesville, GA 30501-7443
Phone
(770) 257-5324
NPI assigned
Mar 24, 2020
Last updated
Jul 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeff Perry
Title
VP Rev Cycle
Phone
(502) 418-4700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

2324 Limestone Overlook Ste 200
Gainesville, GA 30501-7443

Mailing address

PO Box 737896
Dallas, TX 75373-7896
Phone (888) 717-5383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231103002222 GA Part B Supplier - Clinic/Group Practice 4082061635 Receives reassigned benefits from 18 practitioners
Practice locations: Braselton, GA; Gainesville, GA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1003443722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 737896",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753737896",
            "telephone_number": "888-717-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 LIMESTONE OVERLOOK STE 200",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017443",
            "telephone_number": "770-257-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE LANIER ANESTHESIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-24",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VP REV CYCLE",
        "authorized_official_telephone_number": "502-418-4700"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.