Active NPI
Georgina Kesterson, MD
- Anesthesiology Physician
- Johns Creek, GA
National Provider Identifier
1245201250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 33167
- Practice address
- 10579 Bent Tree VW
Johns Creek, GA 30097-5988 - Phone
- (901) 482-0207
- Fax
- (828) 484-2057
- NPI assigned
- Jan 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 22804 | MS | |
| Anesthesiology Physician | 207L00000X | 27587 | TN | |
| Anesthesiology Physician | 207L00000X | 33167 | GA | Primary |
Addresses
Primary practice location
10579 Bent Tree VW
Johns Creek, GA 30097-5988
Mailing address
10579 Bent Tree VW
Johns Creek, GA 30097-5988
Phone (901) 482-0207
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00126012 | Medicaid | MS | |
| 3097335 | Medicaid | TN | |
| 208281006 | Medicaid | MO | |
| 97274 | Other | AR | BLUECROSS BLUESHIELD |
| 3076997 | Other | TN | BLUECROSS BLUESHIELD |
| 129644001 | Medicaid | AR | |
| 50048038 | Other | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33167 | GA | MD | Anesthesiology Physician |
| 22804 | MS | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559779200000",
"number": "1245201250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10579 BENT TREE VW",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300975988",
"telephone_number": "901-482-0207",
"fax_number": "828-484-2057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10579 BENT TREE VW",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300975988",
"telephone_number": "901-482-0207",
"fax_number": "828-484-2057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KESTERSON",
"first_name": "GEORGINA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-28",
"last_updated": "2019-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MS",
"license": "22804",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TN",
"license": "27587",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "GA",
"license": "33167",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00126012",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3097335",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208281006",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "97274",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "3076997",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129644001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "50048038",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Johns Creek, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.