Individual provider Active NPI

Brent H. Suddeth, CRNA

  • Certified Registered Nurse Anesthetist
  • Canton, GA
National Provider Identifier
1063480457
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN149420 Issued in GA
Practice address
201 Hospital Rd
Anesthesia Dept
Canton, GA 30114-2408
Phone
(404) 851-6500
Fax
(770) 237-1124
NPI assigned
Mar 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 RN149420 GA Primary

Addresses

Primary practice location

201 Hospital Rd
Anesthesia Dept
Canton, GA 30114-2408

Mailing address

PO Box 465686
Lawrenceville, GA 30042-5686
Phone (770) 237-1561

Other identifiers 1

IdentifierTypeStateIssuer
RN149420OtherGAGA NURSING LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040715000385 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567441405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 19, 2011 Accepting new patients
Gastrointestinal Specialist of Georgia CurrentSince Jun 1, 2015 Accepting new patients
Northside Cherokee Anesthesia Consultants, PC Past Accepting new patients
Northside Cherokee Anesthesia Associates Past Accepting new patients

Locations

1265 Highway 54 W
Ste 401
Fayetteville, GA 30214
Phone (678) 617-6505

880 Crestmark Dr
Ste 102
Lithia Springs, GA 30122
Phone (678) 388-2040

711 Canton Rd NE
Ste 300
Marietta, GA 30060
Phone (678) 741-2317

118 Mill St
Ste 100
Woodstock, GA 30188
Phone (678) 741-2317

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063480457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 465686",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300425686",
            "telephone_number": "770-237-1561",
            "fax_number": "770-237-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HOSPITAL RD",
            "address_2": "ANESTHESIA DEPT",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142408",
            "telephone_number": "404-851-6500",
            "fax_number": "770-237-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDETH",
        "first_name": "BRENT",
        "middle_name": "H.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN149420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA NURSING LICENSE",
            "identifier": "RN149420",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.