Individual provider Active NPI

Nyah Sappia Venn, CSA

  • Surgical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1093493538
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
23-461 Issued in GA
Practice address
5881 Glenridge Dr Ste 120
Atlanta, GA 30328-8184
Phone
(404) 303-7703
Fax
(404) 303-7706
NPI assigned
Jul 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 23-461 GA Primary

Addresses

Primary practice location

5881 Glenridge Dr Ste 120
Atlanta, GA 30328-8184

Mailing address

PO Box 420827
Atlanta, GA 30342-0827
Phone (404) 303-7703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23-461GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Surgical Associates Inc PastSince Jul 9, 2023 Accepting new patients
Superior Surgical Associates Inc PastSince Jul 9, 2023 Accepting new patients

Organizations & group practices 2

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": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1093493538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303420827",
            "telephone_number": "404-303-7703",
            "fax_number": "404-303-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5881 GLENRIDGE DR STE 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303288184",
            "telephone_number": "404-303-7703",
            "fax_number": "404-303-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENN",
        "first_name": "NYAH",
        "middle_name": "SAPPIA",
        "credential": "CSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "23-461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.