Mary A Justyn, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP9183190 Issued in FL

Practice address

1900 Tebeau St
Waycross, GA 31501-6357

Phone

(912) 338-6511

Fax

(912) 338-6512

NPI assigned

Apr 4, 2007

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sentry Anesthesia Management, LLCGroup PAC ID 9436372323, 170 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Liberty Regional Medical Center Hospital, Hinesville, GA, CCN 111335

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 and National Provider Directory roles.

• Sentry Anesthesia Management, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1134544794
  Medicare reassignment Care Compare group NPD
• Patriot Anesthesia LLC

  • Anesthesiology Physician
  • Hinesville, GA
  • NPI 1952840449
  Medicare reassignment NPD
• Southeast Georgia Anesthesia LLC

  • Anesthesiology Physician
  • Waycross, GA
  • NPI 1265518849
  Medicare reassignment NPD
• Institute for Corrective Surgery of the Foot & Ankle, Inc.

  • Ambulatory Surgical Clinic/Center
  • Waycross, GA
  • NPI 1720023237
  NPD
• North Florida Anesthesia Consultants, Inc.

  • Anesthesiology Physician
  • St Augustine, FL
  • NPI 1114892361
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospital Authority of Liberty County

  • Critical Access Hospital
  • Hinesville, GA
  • NPI 1326079260
  Care Compare affiliation

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1275655987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1888 GARDENIA ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341908",
            "telephone_number": "904-261-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TEBEAU ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016357",
            "telephone_number": "912-338-6511",
            "fax_number": "912-338-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTYN",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9183190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000941817D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kandallu R Ramesh, MD, PC
• Mary Kilcoyne, FNP-C

• Certified Registered Nurse Anesthetist in Waycross, GA
• Providers in Waycross, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.