Individual provider Active NPI

Collin Schalk

  • Certified Registered Nurse Anesthetist
  • Cartersville, GA
National Provider Identifier
1174201768
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
268738 Issued in GA
Practice address
960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Phone
(470) 490-1000
NPI assigned
Jul 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 268738 GA
Certified Registered Nurse Anesthetist 367500000X 268738 GA Primary

Addresses

Primary practice location

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129

Mailing address

8946 Interline Ave
Baton Rouge, LA 70809-1913
Phone (678) 446-5215

Other practice location 1

11 Upper Riverdale Road
Riverdale, GA 30274
Phone (770) 991-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231119000083 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769830496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Emory University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverdale Anesthesia Services LLCGroup PAC ID 2163952284, 21 clinicians
Dpi of Georgia LLCGroup PAC ID 0941546923, 30 clinicians

Practice addresses (Care Compare)

11 Upper Riverdale Rd SW
Riverdale, GA 30274-2615
Phone (770) 991-8000

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Phone (225) 923-0030

Hospital & facility affiliations

  • Piedmont Cartersville Medical Center Hospital, Cartersville, GA, CCN 110030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
268738GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Riverdale Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 20, 2025 Accepting new patients
Dpi of Georgia, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2023 Accepting new patients

Locations

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

300 Colonial Center Pkwy
Ste 100N
Roswell, GA 30076
Phone (704) 684-7609

8946 Interline Ave
Ste C
Baton Rouge, LA 70809
Phone (225) 529-1143

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": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1174201768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8946 INTERLINE AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708091913",
            "telephone_number": "678-446-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOE FRANK HARRIS PKWY SE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202129",
            "telephone_number": "470-490-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Upper Riverdale Road",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "30274",
            "country_code": "US",
            "telephone_number": "770-991-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHALK",
        "first_name": "COLLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "268738",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "268738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.