Individual provider Active NPI

Pamela G Miller, CRNA

  • Certified Registered Nurse Anesthetist
  • Lagrange, GA
National Provider Identifier
1265674402
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN161397 CRNA Issued in GA
Practice address
1805 Vernon Rd
Suite C
Lagrange, GA 30240-3871
Phone
(706) 812-9902
NPI assigned
Apr 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN161397 CRNA GA Primary
Certified Registered Nurse Anesthetist 367500000X TMP141143 KS

Addresses

Primary practice location

1805 Vernon Rd
Suite C
Lagrange, GA 30240-3871

Mailing address

138 Chandlers Run
Newnan, GA 30263-6196

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100429000942 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527195155 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mulkey Anesthesiology Associates, PCGroup PAC ID 6406035583, 22 clinicians
Perimeter Anesthesia LLCGroup PAC ID 2567763048, 16 clinicians

Practice addresses (Care Compare)

3870 Medical Park Dr
Suite 100
Austell, GA 30106-1110
Phone (770) 929-9033

505 Jenkins St
Lagrange, GA 30240-4225
Phone 88840802002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN161397 CRNAGAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CSP Anesthesia LLC CurrentSince Oct 22, 2019 Accepting new patients
Mulkey Anesthesiology Associates LLC CurrentSince May 1, 2019 Accepting new patients
Alta Anesthesia Associates of Georgia, PC Nurse Anesthetist, Certified Registered CurrentSince Aug 30, 2010 Accepting new patients
Perimeter Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 30, 2019 Accepting new patients
Interventional Spine and Pain Management Ambulatory Surgical Center CurrentSince May 1, 2019 Accepting new patients
Sleep Ezzy CurrentSince Jul 3, 2023 Accepting new patients
Anesthesia Consulting Services, PA Past Accepting new patients
Redmond Anesthesia Services LLC Past Accepting new patients
Anesthesia Services of North Georgia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3390 Peachtree Rd NE
Ste 1500
Atlanta, GA 30326
Phone 40492049502501

3870 Medical Park Dr
Ste 100
Austell, GA 30106

3870 Medical Park Dr
Austell, GA 30106
Phone (770) 923-7778

1255 Friendship Rd
Ste 140
Braselton, GA 30517

3100 Kemble Ave
Brunswick, GA 31520
Phone (880) 233-2570

777 Gloucester St
Brunswick, GA 31520
Phone (912) 264-9930

1388 Wellbrook Cir NE
Conyers, GA 30012

1388 Wellbrook Cir NE
Ste 1500
Conyers, GA 30012

1388 Wellbrook Cir NE
#A
Conyers, GA 30012
Phone (770) 385-7985

5303 Adams St NE
Covington, GA 30014
Phone (404) 786-0643

505 Jenkins St
Lagrange, GA 30240
Phone (706) 407-0161

892 Legacy Park Dr
Lawrenceville, GA 30043

455 Philip Blvd
Ste 138
Lawrenceville, GA 30046

939 Bob Arnold Blvd
Ste G
Lithia Springs, GA 30122
Phone (470) 827-3648

1400 Veterans Memorial Hwy SE
Ste 134
Mableton, GA 30126
Phone (404) 254-6696

5505 Roswell Rd
Ste 350B
Sandy Springs, GA 30342

403 Permian Way
Ste D
Villa Rica, GA 30180
Phone (470) 827-3648

403 Permian Way
Ste C
Villa Rica, GA 30180
Phone (404) 998-5537

403 Permian Way
Villa Rica, GA 30180
Phone (678) 840-4034

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1265674402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 CHANDLERS RUN",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302636196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 VERNON RD",
            "address_2": "SUITE C",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403871",
            "telephone_number": "706-812-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "PAMELA",
        "middle_name": "G",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-02",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN161397  CRNA",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "TMP141143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.