Active NPI
John G Anderson, CRNA
- Certified Registered Nurse Anesthetist
- Dunwoody, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN065882
- Practice address
- 4575 N Shallowford Rd
Dunwoody, GA 30338-6445 - Phone
- (770) 454-4286
- Fax
- (770) 454-4065
- NPI assigned
- May 24, 2006
- Last updated
- Jan 7, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN065882 | GA | Primary |
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
Electronic endpoints 1
| 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 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.51 of 100
- Quality
- 80.61
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN065882 | GA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Emory Clinic Inc | Current | Accepting new patients | |
| Emory Specialty Associates, LLC | Current | Accepting new patients | |
| Newnan Anesthesia Associates, LLC | Past | Accepting new patients | |
| Sumter Regional Medical Group, PC | Past | Accepting new patients | |
| Tri-County Anesthesia, LLC | Past | Accepting new patients | |
| Americus & Sumter County Hospital Authority | 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
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Lagrange, GA
- NPI 1407864168
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1396798229
-
dba Sumter Regional Hospital
- Rehabilitation Hospital Unit
- Americus, GA
- NPI 1164517173
-
- Anesthesiology Physician
- Newnan, GA
- NPI 1033300298
-
- Certified Registered Nurse Anesthetist
- Albany, GA
- NPI 1437140084
Nurse Anesthetist, Certified Registered
-
- Specialist
- Americus, GA
- NPI 1073685996
-
- Anesthesiology Physician
- Douglasville, GA
- NPI 1073687422
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Emory University dba Emory Crawford Long Hospital
- General Acute Care Hospital
- Atlanta, GA
- NPI 1144203563
-
dba Emory University Hospital
- General Acute Care Hospital
- Atlanta, GA
- NPI 1588640692
-
dba Emory University Hospital At Wesley Woods
- General Acute Care Hospital
- Atlanta, GA
- NPI 1770560294
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1023063161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 70128",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300070128",
"telephone_number": "770-578-1800",
"fax_number": "770-578-6168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4575 N SHALLOWFORD RD",
"city": "DUNWOODY",
"state": "GA",
"postal_code": "303386445",
"telephone_number": "770-454-4286",
"fax_number": "770-454-4065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JOHN",
"middle_name": "G",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2022-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "GA",
"license": "RN065882",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "750 Townpark Ln NW",
"city": "Kennesaw",
"state": "GA",
"country_code": "US",
"postal_code": "301445579",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Dunwoody, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.