Individual provider Active NPI

Keith M McLendon, MD

  • Anesthesiology Physician
  • Atlanta, GA
National Provider Identifier
1164418109
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
31628 Issued in GA
Practice address
1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone
(770) 645-9181
Fax
(770) 645-8455
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 31628 GA Primary

Addresses

Primary practice location

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606

Mailing address

3155 N Point Pkwy
Attn: Credentialing Dept., Building F Suite 100
Alpharetta, GA 30005
Phone (770) 645-9181

Other identifiers 3

IdentifierTypeStateIssuer
050012993OtherRAILROAD MEDICARE
000404621EMedicaidGA
000404621BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000510 GA Practitioner - Anesthesiology 1850429812 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Emory University School of Medicine, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Practice addresses (Care Compare)

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31628GAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mak Anesthesia Holdings LLC Anesthesiology CurrentSince Nov 21, 2022 Accepting new patients
North Atlanta Anesthesia Professionals, LLC Anesthesiology CurrentSince Sep 1, 2022 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

4500 Hospital Blvd
Ste 210
Roswell, GA 30076

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

5730 Glenridge Dr
Ste 400
Sandy Springs, GA 30328
Phone (404) 252-3074

1100 Johnson Fy Rd NE
Ste 130
Sandy Springs, GA 30342
Phone (404) 531-9988

4441 Atlanta Rd SE
Ste 312
Smyrna, GA 30080
Phone (470) 956-4200

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1164418109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 N POINT PKWY",
            "address_2": "ATTN: CREDENTIALING DEPT., BUILDING F SUITE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-645-9181",
            "fax_number": "770-645-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "770-645-9181",
            "fax_number": "770-645-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLENDON",
        "first_name": "KEITH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "31628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050012993",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000404621E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000404621B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.