NPIMap

Organization Active NPI

Medical Center Anesthesiology of Athens

  • Anesthesiology Physician
  • Athens, GA
National Provider Identifier
1003863291
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MEDICAL CENTER ANESTHESIOLOGY OF ATHENS
Practice address
1199 Prince Ave
Athens, GA 30606-2797
Phone
(706) 543-3449
Fax
(706) 543-5744
NPI assigned
May 31, 2006
Last updated
Jan 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Authorized official

Name
Joyce Martin
Title
Credentialing
Phone
(888) 550-4266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1199 Prince Ave
Athens, GA 30606-2797

Mailing address

PO Box 3209
Indianapolis, IN 46206-3209
Phone (706) 543-3447

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000797 GA Part B Supplier - Clinic/Group Practice 1456246230 Receives reassigned benefits from 91 practitioners
Practice locations: Athens, GA

National Provider Directory

National Provider Directory

Locations

2142 W Broad St
Bldg 100
Athens, GA 30606
Phone (706) 548-6881

Practitioners & affiliated clinicians

Practitioners 133

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 133

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1003863291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3209",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063209",
            "telephone_number": "706-543-3447",
            "fax_number": "706-543-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062797",
            "telephone_number": "706-543-3449",
            "fax_number": "706-543-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER ANESTHESIOLOGY OF ATHENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "888-550-4266"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.