Individual provider Active NPI

Demetra D McGlothin, CRNA

  • Certified Registered Nurse Anesthetist
  • Macon, GA
National Provider Identifier
1023313004
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN149967 Issued in GA
Practice address
777 Hemlock St
Macon, GA 31201-2102
Phone
(866) 507-5244
Fax
(855) 851-4405
NPI assigned
Jan 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN149967 GA Primary

Addresses

Primary practice location

777 Hemlock St
Macon, GA 31201-2102

Mailing address

PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110310000887 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335321447 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Mercer University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC-West Georgia Anesthesia Associates Inc.Group PAC ID 2365456308, 67 clinicians

Practice addresses (Care Compare)

705 Dixie St
Carrollton, GA 30117-3818
Phone (800) 232-5703

Hospital & facility affiliations

  • Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN149967GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
TMC-West Georgia Anesthesia Associates Inc. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2015 Accepting new patients
Coastal Ambulatory Anesthesia LLC CurrentSince Jun 1, 2025 Accepting new patients
Gi Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Nov 1, 2014 Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499

1014 Forsyth St
Macon, GA 31201
Phone (478) 633-5800

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200

900 Towne Lake Pkwy
Ste 310
Woodstock, GA 30189
Phone (770) 926-0071

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1023313004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "855-851-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "866-507-5244",
            "fax_number": "855-851-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLOTHIN",
        "first_name": "DEMETRA",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN149967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.