Individual provider Active NPI

Michael W. Hurst, PAAA

  • Anesthesiologist Assistant
  • Marietta, GA
National Provider Identifier
1184612293
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
2564 Issued in GA
Practice address
2550 Windy Hill Rd SE
Suite 302
Marietta, GA 30067-8665
Phone
(678) 574-0943
Fax
(678) 574-0943
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 2564 GA Primary

Addresses

Primary practice location

2550 Windy Hill Rd SE
Suite 302
Marietta, GA 30067-8665

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
100002545DMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000319 GA Practitioner - Anesthesiology Assistant 4981676178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 1994
Medicare assignment
May accept Medicare assignment
Group practices
Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Practice addresses (Care Compare)

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 702-1806

Hospital & facility affiliations

  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
2564GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Concordia Anesthesiology, Inc CurrentSince May 18, 2015 Accepting new patients
Mak Anesthesia Holdings LLC CurrentSince Jan 31, 2017 Accepting new patients
Ambulatory Anesthesia of Atlanta, P C Past Accepting new patients
Georgia Anesthesiologists, PC Past Accepting new patients
Henry Anesthesia Associates LLC Past Accepting new patients
Fayette Community Anesthesia Past Accepting new patients

Locations

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

1457 Scott Blvd
Decatur, GA 30030
Phone (404) 292-2500

1266 Highway 515 S
Jasper, GA 30143
Phone (706) 301-5350

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

895 Canton Rd NE
Bldg 200
Marietta, GA 30060
Phone (678) 784-0203

2550 Windy Hill Rd SE
Ste 218
Marietta, GA 30067
Phone (770) 933-1900

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

11650 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 543-8132

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

Organizations & group practices 6

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1184612293",
    "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": "2550 WINDY HILL RD SE",
            "address_2": "SUITE 302",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678665",
            "telephone_number": "678-574-0943",
            "fax_number": "678-574-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "MICHAEL",
        "middle_name": "W.",
        "credential": "PAAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "2564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002545D",
            "state": "GA"
        }
    ],
    "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 Sep 18, 2008; 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.