NPIMap

Individual provider Active NPI

Joann L Carson

  • Certified Registered Nurse Anesthetist
  • Carrollton, GA
National Provider Identifier
1194795047
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN130954CRNA Issued in GA
Practice address
160 Clinic Ave
Carrollton, GA 30117-4451
Phone
(770) 834-1008
Fax
(770) 834-2531
NPI assigned
Jan 24, 2006
Last updated
May 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN130954CRNA GA Primary

Addresses

Primary practice location

160 Clinic Ave
Carrollton, GA 30117-4451

Mailing address

9488 Lakeview CT
Douglasville, GA 30135
Phone (770) 947-4210

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051230000531 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345137121 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN130954CRNAGAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 15, 2013 Accepting new patients
Nmda Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 26, 2012 Accepting new patients
WGG Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2011 Accepting new patients
Paulding Anesthesia Associates, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Newnan Anesthesia Associates, LLC Past Accepting new patients
Parkway Anesthesia Consultants, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Alta Anesthesia Associates of Georgia, PC Nurse Anesthetist, Certified Registered PastSince Nov 11, 2012 Accepting new patients
Southern Crescent Anesthesiology, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
West Ga. Nurse Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Southern Crescent Nurse Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Calhoun Anesthesia P C Past Accepting new patients
Georgia Anesthesiologists, PC PastSince Oct 1, 2015 Accepting new patients

Locations

158 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-1008

160 Clinic Ave
Carrollton, GA 30117
Phone (770) 214-2800

1265 Highway 54 W
Ste 401
Fayetteville, GA 30214
Phone (678) 617-6505

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336694400000",
    "number": "1194795047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9488 LAKEVIEW CT",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30135",
            "telephone_number": "770-947-4210",
            "fax_number": "770-830-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CLINIC AVE",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174451",
            "telephone_number": "770-834-1008",
            "fax_number": "770-834-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "JOANN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2012-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN130954CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.