NPIMap

Organization Active NPI

Capitol Anesthesiology, PC

  • Anesthesiology Physician
  • Morrow, GA
National Provider Identifier
1245287192
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
CAPITOL ANESTHESIOLOGY, PC
Practice address
6649 Lake Dr
Morrow, GA 30260-2354
Phone
(770) 968-9978
Fax
(770) 968-9975
NPI assigned
May 27, 2006
Last updated
Jan 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Authorized official

Name
Jan Kersey
Title
Administrator
Phone
(770) 968-9978

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X GA Primary

Addresses

Primary practice location

6649 Lake Dr
Morrow, GA 30260-2354

Mailing address

PO Box 278
Jonesboro, GA 30237-0278
Phone (770) 968-9978

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040507000216 GA Part B Supplier - Clinic/Group Practice 5799774642 Receives reassigned benefits from 50 practitioners
Practice locations: Atlanta, GA; Fayetteville, GA; Morrow, GA; Stockbridge, GA

National Provider Directory

National Provider Directory

Locations

98 Annex
#618
Atlanta, GA 30398
Phone (770) 473-6000

156 Foster Dr
Spc C
McDonough, GA 30253

6649 Lake Dr
Morrow, GA 30260

1100 Lake Hearn Dr
Ste 410
Sandy Springs, GA 30342
Phone (404) 252-9991

Practitioners & affiliated clinicians

Practitioners 124

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 124

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1245287192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302370278",
            "telephone_number": "770-968-9978",
            "fax_number": "770-968-9975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6649 LAKE DR",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602354",
            "telephone_number": "770-968-9978",
            "fax_number": "770-968-9975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITOL ANESTHESIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "KERSEY",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-968-9978"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.