John G Anderson, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Dunwoody, GA
NPI 1023063161 · NPPES record last updated Jan 7, 2022
Key facts
- NPI
- 1023063161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- RN065882 (GA)
- Practice address
- 4575 N Shallowford Rd
Dunwoody, GA 30338-6445 - Phone
- (770) 454-4286
- Fax
- (770) 454-4065
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Emory Specialty Associates, LLC
Practice addresses (Care Compare)
1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812
Hospital & facility affiliations
- Emory University Hospital
- Emory University Hospital Midtown
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.51 of 100
- Quality
- 80.61
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040310000316 | GA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 3375431323 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emory Specialty Associates, LLC | Current |
Accepting new patients | |
| The Emory Clinic Inc | Current |
Accepting new patients | |
| Tri-County Anesthesia, LLC | Past | Accepting new patients | |
| Americus & Sumter County Hospital Authority | Past | Accepting new patients | |
| Sumter Regional Medical Group, PC | Past | Accepting new patients | |
| Newnan Anesthesia Associates, LLC | Past | Accepting new patients | |
| Palmyra Professional Fees LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525
1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812
101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889
8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584
4575 N Shallowford Rd
Dunwoody, GA 30338
Phone (404) 454-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN065882 | GA | Yes |
Addresses
Primary practice location
4575 N Shallowford Rd
Dunwoody, GA 30338-6445
Mailing address
PO Box 70128
Marietta, GA 30007-0128
Phone (770) 578-1800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000550569L | Medicaid | GA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Permanente Medical Group |
Other providers in Dunwoody, GA
- Amanda Morse Counseling, LLC
- Sherita Amin
- Amy Zoller Lee PA-C LLC
- Anchor Point Home Care LLC
- Anchored & Whole Wellness, LLC
- Jonielle Monet Anderson
- Shamika Anderson
- Su Yung Anderson
- Steven Michael Andrews
- Anna Gray Therapy, LLC
All providers in Dunwoody, GA · Certified Registered Nurse Anesthetist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.