Individual provider Active NPI

Edith Nottage, CRNA

  • Certified Registered Nurse Anesthetist
  • Jamaica, NY
National Provider Identifier
1083755128
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN310003 Issued in GA
Practice address
8900 Van Wyck Expy
Jamaica, NY 11418-2897
Phone
(718) 206-6290
NPI assigned
Feb 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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 AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X RN310003 GA Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Jamaica, NY 11418-2897

Mailing address

8900 Van Wyck Expy
Jamaica, NY 11418-2897
Phone (718) 206-6290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050506000154 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971542523 Reassigns benefits to 1 organization
I20230426003261 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971542523 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
RN310003GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Ambulatory Anesthesia LLC Single Specialty CurrentSince Mar 1, 2023 Accepting new patients
Gi Anesthesia of Georgia LLC Single Specialty CurrentSince Mar 1, 2023 Accepting new patients
Jamaica Anesthesiologist, PC Single Specialty CurrentSince Mar 7, 2005 Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

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

301 Philip Blvd
Ste B
Lawrenceville, GA 30046
Phone (770) 682-7220

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

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1083755128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTTAGE",
        "first_name": "EDITH",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN310003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.