Organization Active NPI

Integra Anesthesia Associates LLC

  • Certified Registered Nurse Anesthetist
  • Rome, GA
National Provider Identifier
1184876682
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
INTEGRA ANESTHESIA ASSOCIATES LLC
Practice address
1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone
(706) 767-8347
NPI assigned
Oct 15, 2008
Last updated
Jul 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Authorized official

Name
Phyllis A Pemerton, RN, MBA
Title
Chief Operating Officer
Phone
(706) 767-8347

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1825 Martha Berry Blvd NW
Rome, GA 30165-1625

Mailing address

519 Broad St
Suite 106
Rome, GA 30161-1734
Phone (706) 767-8347

National Provider Directory

National Provider Directory

Locations

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

519 Broad St
Ste 106
Rome, GA 30161
Phone (706) 346-4435

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435795200000",
    "number": "1184876682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 BROAD ST",
            "address_2": "SUITE 106",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301611734",
            "telephone_number": "706-767-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651625",
            "telephone_number": "706-767-8347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRA ANESTHESIA ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2015-07-02",
        "status": "A",
        "authorized_official_last_name": "PEMERTON",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "706-767-8347",
        "authorized_official_credential": "RN, MBA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.