Individual provider Active NPI

John Albert Pearson III, CAA

  • Anesthesiologist Assistant
  • Savannah, GA
National Provider Identifier
1215659115
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
4700 Waters Ave
Savannah, GA 31404-6220
Phone
(912) 704-7826
NPI assigned
Sep 16, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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 Primary

Addresses

Primary practice location

4700 Waters Ave
Savannah, GA 31404-6220

Mailing address

1285 Belle Island Rd
Richmond Hill, GA 31324-6028

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230104001110 GA Practitioner - Anesthesiology Assistant 4981074150 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Georgia Anesthesia, LLCGroup PAC ID 8426466137, 114 clinicians

Practice addresses (Care Compare)

4700 Waters Ave
(Memorial Health University Medical Center)
Savannah, GA 31404-6220
Phone (912) 350-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC CurrentSince Oct 6, 2022 Accepting new patients
SE Georgia Anesthesia, LLC CurrentSince Nov 11, 2023 Accepting new patients

Locations

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

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": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1215659115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 BELLE ISLAND RD",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313246028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-704-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "JOHN",
        "middle_name": "ALBERT",
        "name_suffix": "III",
        "credential": "CAA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.