Active NPI
Wynhdam George Mortimer, MD
- Anesthesiology Physician
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 29045
- Practice address
- 1968 Peachtree Road NW
Atlanta, GA 30309-1281 - Phone
- (404) 351-1745
- Fax
- (404) 351-7121
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 29045 | GA | Primary |
| Anesthesiology Physician | 207L00000X | 029045 | GA |
Addresses
Primary practice location
1968 Peachtree Road NW
Atlanta, GA 30309-1281
Mailing address
PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839
Other practice location 1
1265 Highway 54 W Ste 103
Fayetteville, GA 30214-4537
Phone (678) 216-0771
Other practice location 2
1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone (404) 351-1745
Other practice location 3
745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 400-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0035167 | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Ohio State University College of Medicine, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (800) 242-1131
1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 351-1745
745 Poplar Rd
Newnan, GA 30265-1618
Phone (404) 351-1745
Hospital & facility affiliations
- Piedmont Fayette Hospital
- Piedmont Hospital, Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29045 | GA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Piedmont Anesthesia Associates, L.L.C | Anesthesiology | Current | Accepting new patients |
| Piedmont Anesthesia LLC | Anesthesiology | Current | Accepting new patients |
| Fayette Community Anesthesia | Anesthesiology | Past | Accepting new patients |
| American Anesthesiology Associates of Georgia, LLC | Anesthesiology | Past | Accepting new patients |
Locations
1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222
1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754
1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000
1265 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-7000
1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911
1265 Highway 54 W
Ste 103
Fayetteville, GA 30214
Phone (678) 216-0771
745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785
1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Stockbridge, GA
- NPI 1700474244
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1407856594
-
- Anesthesiology Physician
- Stone Mountain, GA
- NPI 1528068673
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1144220245
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fayetteville, GA
- NPI 1528027240
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1962461681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685404800000",
"number": "1235155367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 551420",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333551420",
"telephone_number": "800-243-3839",
"fax_number": "954-839-2569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1968 PEACHTREE ROAD NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303091281",
"telephone_number": "404-351-1745",
"fax_number": "404-351-7121"
}
],
"practiceLocations": [
{
"address_1": "1265 Highway 54 W Ste 103",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "GA",
"postal_code": "302144537",
"country_code": "US",
"telephone_number": "678-216-0771",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1255 Highway 54 W",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "GA",
"postal_code": "302144526",
"country_code": "US",
"telephone_number": "404-351-1745",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "745 Poplar Rd",
"address_purpose": "LOCATION",
"city": "Newnan",
"state": "GA",
"postal_code": "302651618",
"country_code": "US",
"telephone_number": "770-400-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORTIMER",
"first_name": "WYNHDAM",
"middle_name": "GEORGE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2023-05-30",
"certification_date": "2023-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "GA",
"license": "29045",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "GA",
"license": "029045",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0035167",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.