Individual provider Active NPI

Mark Sean Bennett, CRNA

  • Certified Registered Nurse Anesthetist
  • Atlanta, GA
National Provider Identifier
1104887736
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN123243 Issued in GA
Practice address
550 Peachtree St
Suite 1600
Atlanta, GA 30308-2209
Phone
(404) 253-6820
Fax
(404) 874-1249
NPI assigned
Mar 31, 2006
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 RN123243 GA Primary

Addresses

Primary practice location

550 Peachtree St
Suite 1600
Atlanta, GA 30308-2209

Mailing address

Dept 1029 PO Box 740209
Atlanta, GA 30374-0209
Phone (941) 360-1566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180305001951 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648289108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gi Alliance Anesthesia of Florida PLLC 11 clinicians

Practice addresses (Care Compare)

5645 S Military TRL
Lake Worth, FL 33463-6978
Phone (833) 964-1135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN123243GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gi Alliance Anesthesia of Florida, PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients
St. Mary'S Good Samaritan Hospital, Inc. Current Accepting new patients
Bethesda Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Bethesda Anesthesia Associates, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Ambulatory Anesthesia of North Georgia, LLC Past Accepting new patients
Augusta University Past Accepting new patients
Anesthesia Associates of Gainesville, LLC Past Accepting new patients

Locations

5645 S Military Trl
Lake Worth, FL 33463
Phone (561) 689-4500

5401 Lake Oconee Pkwy
Greensboro, GA 30642
Phone (706) 453-7331

Organizations & group practices 7

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104887736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 1029 PO BOX 740209",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740209",
            "telephone_number": "941-360-1566",
            "fax_number": "941-358-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST",
            "address_2": "SUITE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082209",
            "telephone_number": "404-253-6820",
            "fax_number": "404-874-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARK",
        "middle_name": "SEAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN123243",
            "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 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.