John Gary Hartzog, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1-039697 Issued in AL

Practice address

470 Taylor Rd
Montgomery, AL 36117-3563

Phone

(334) 226-4048

Fax

(334) 323-5675

NPI assigned

Apr 17, 2006

Last updated

Sep 23, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Anesthesia of Montgomery PCGroup PAC ID 5799684148, 117 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Anesthesia of Montgomery PC

  • Anesthesiology Physician
  • Montgomery, AL
  • NPI 1780636233

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1255395190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 OLD ROCKY RIDGE ROAD",
            "address_2": "SUITE 106",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352167251",
            "telephone_number": "205-989-1080",
            "fax_number": "205-989-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173563",
            "telephone_number": "334-226-4048",
            "fax_number": "334-323-5675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Pepperell Pkwy",
            "address_purpose": "LOCATION",
            "city": "Opelika",
            "state": "AL",
            "postal_code": "368015452",
            "country_code": "US",
            "telephone_number": "334-528-2499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTZOG",
        "first_name": "JOHN",
        "middle_name": "GARY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-039697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222102",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "512-14837",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "430045002",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "430071799",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hart Chiropractic LLC (Hart Spine & Rehab)
• Jason R Hart, DC
• Denys Hartley, APRN, FNP-C
• Randi Certrina Hartsfield, LGSW
• Charles Wayne Hartzog Jr., MD
• Patricia F. Hartzog, CRNA
• Alicia Harvey
• Lakinya Harvey
• Melodye M Harvey, FNP
• Melissa Shea Harville, LPTA

• Certified Registered Nurse Anesthetist in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Certified Registered Nurse Anesthetist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.