Individual provider Active NPI

Alie Mulkey

  • Anesthesiologist Assistant
  • Macon, GA
National Provider Identifier
1205486362
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
9408 Issued in GA
Practice address
770 Pine St Ste L40
Macon, GA 31201-7521
Phone
(478) 633-1190
NPI assigned
Sep 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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 9408 GA Primary

Addresses

Primary practice location

770 Pine St Ste L40
Macon, GA 31201-7521

Mailing address

205 Robbie CT
Warner Robins, GA 31088-2356
Phone (706) 346-9605

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200306002536 GA Practitioner - Anesthesiology Assistant 7214365154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Oakland College of Medicine and Surgery, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redmond Anesthesia and Pain Treatment, PCGroup PAC ID 4880841741, 77 clinicians

Practice addresses (Care Compare)

501 Redmond Rd NW
Rome, GA 30165-1415
Phone (706) 291-0291

Hospital & facility affiliations

  • Adventhealth Redmond Hospital, Rome, GA, CCN 110168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9408GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Redmond Anesthesia and Pain Treatment, PC CurrentSince Sep 24, 2023 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Dec 16, 2019 Accepting new patients

Locations

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

888 Pine St
Macon, GA 31201
Phone (478) 751-0527

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

1014 Forsyth St
Macon, GA 31201
Phone (478) 633-5800

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

16 John Maddox Dr NW
Rome, GA 30165
Phone (706) 234-0315

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": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1205486362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ROBBIE CT",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310882356",
            "telephone_number": "706-346-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE L40",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017521",
            "telephone_number": "478-633-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULKEY",
        "first_name": "ALIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "9408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.