NPIMap

Organization Active NPI

SG Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Lawrenceville, GA
National Provider Identifier
1053750646
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
SG ANESTHESIA LLC
Practice address
763 Old Norcross Rd
Lawrenceville, GA 30046-4317
Phone
(706) 623-4271
NPI assigned
Jun 18, 2013
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 L Perry
Title
VP of RCM
Phone
(502) 418-4700

Specialties & licenses 2

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

Addresses

Primary practice location

763 Old Norcross Rd
Lawrenceville, GA 30046-4317

Mailing address

PO Box 738872
Dallas, TX 75373-8872
Phone (888) 717-5383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130912000589 GA Part B Supplier - Clinic/Group Practice 3072757079 Receives reassigned benefits from 113 practitioners
Practice locations: Lawrenceville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 115

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 115

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1053750646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 738872",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753738872",
            "telephone_number": "888-717-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464317",
            "telephone_number": "706-623-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SG ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP OF RCM",
        "authorized_official_telephone_number": "502-418-4700"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, 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.