Active NPI
Russell L. Branch Jr., CRNA
- Certified Registered Nurse Anesthetist
- Marietta, GA
National Provider Identifier
1124096862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN174552
- Practice address
- 531 Roselane St NW
Suite 830
Marietta, GA 30060 - Phone
- (770) 794-0477
- Fax
- (770) 794-3108
- NPI assigned
- Mar 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN174552 | GA | Primary |
Addresses
Primary practice location
531 Roselane St NW
Suite 830
Marietta, GA 30060
Mailing address
531 Roselane St NW
Suite 830
Marietta, GA 30060-6913
Phone (770) 794-0477
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)
- Enrolled
- Credentials
- Certified Registered Nurse, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avvsc Lawrenceville, LLC | Current | Accepting new patients | |
| County of Rutherford Office of Budget Director | Past | Accepting new patients | |
| Georgia Interventional Pain - C, LLC | Past | Accepting new patients | |
| Atlanta Sports Medicine Surgery Center | Past | Accepting new patients | |
| Gi Anesthesia of Georgia LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Georgia Interventional Pain - D LLC | Past | Accepting new patients | |
| Georgia Interventional Pain - H, LLC | Past | Accepting new patients |
Locations
600 Professional Dr
Ste 160B
Lawrenceville, GA 30046
Phone (678) 878-4555
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.
-
- Ambulatory Surgical Clinic/Center
- Lawrenceville, GA
- NPI 1427435007
-
- Ambulatory Surgical Clinic/Center
- Atlanta, GA
- NPI 1225179716
-
- Ambulatory Surgical Clinic/Center
- Cumming, GA
- NPI 1497105803
-
- Ambulatory Surgical Clinic/Center
- Decatur, GA
- NPI 1043660442
-
- Ambulatory Surgical Clinic/Center
- Carrollton, GA
- NPI 1225627094
-
- Certified Registered Nurse Anesthetist
- Gainesville, GA
- NPI 1326569187
Nurse Anesthetist, Certified Registered
-
- Land Ambulance
- Murfreesboro, TN
- NPI 1205832797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1124096862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "531 ROSELANE ST NW",
"address_2": "SUITE 830",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300606913",
"telephone_number": "770-794-0477",
"fax_number": "770-794-3108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "531 ROSELANE ST NW",
"address_2": "SUITE 830",
"city": "MARIETTA",
"state": "GA",
"postal_code": "30060",
"telephone_number": "770-794-0477",
"fax_number": "770-794-3108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANCH",
"first_name": "RUSSELL",
"middle_name": "L.",
"name_suffix": "Jr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "GA",
"license": "RN174552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.