NPIMap

Organization Active NPI

Tranquil Anesthesiology LLC

  • Anesthesiology Physician
  • Macon, GA
National Provider Identifier
1235514456
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
TRANQUIL ANESTHESIOLOGY LLC
Practice address
577 Mulberry St Ste 110
Macon, GA 31201-8220
Phone
(888) 728-0882
NPI assigned
Jul 29, 2015
Last updated
Aug 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Authorized official

Name
Richard Douberly, CRNA
Title
Member Manager
Phone
(888) 728-0882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

577 Mulberry St Ste 110
Macon, GA 31201-8220

Mailing address

PO Box 850001 Dept 238
Orlando, FL 32885-4380
Phone (941) 360-1566

Other practice location 1

4080 McGinnis Ferry Rd Ste 102
Alpharetta, GA 30005-3901
Phone (888) 728-0882 ext. 1

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20161202000506 FL Part B Supplier - Clinic/Group Practice 0749598001 Receives reassigned benefits from 28 practitioners
Practice locations: Ormond Beach, FL; Winter Garden, FL; Ocala, FL; Jacksonville, FL
O20170828003743 GA Part B Supplier - Clinic/Group Practice 0749598001 Receives reassigned benefits from 42 practitioners
Practice locations: Tucker, GA; St Simons Island, GA; Lithonia, GA; Brunswick, GA; Savannah, GA
O20190411001693 NC Part B Supplier - Clinic/Group Practice 0749598001 Receives reassigned benefits from 20 practitioners
Practice locations: Lumberton, NC

National Provider Directory

National Provider Directory

Locations

1 E Jackson Blvd
Ste 101
Savannah, GA 31405
Phone (912) 356-3287

1468 Montreal Rd
Ste 200
Tucker, GA 30084
Phone (770) 638-1400

Practitioners & affiliated clinicians

Practitioners 101

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.

View all 101

NPI Registry JSON

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1235514456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001 DEPT 238",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328854380",
            "telephone_number": "941-360-1566",
            "fax_number": "941-358-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 MULBERRY ST STE 110",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018220",
            "telephone_number": "888-728-0882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4080 McGinnis Ferry Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300053901",
            "country_code": "US",
            "telephone_number": "888-728-0882 x1",
            "fax_number": "888-512-1507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRANQUIL ANESTHESIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "DOUBERLY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "888-728-0882",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "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 Aug 18, 2020; 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.