Amanda B Hickerson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN159328 Issued in GA

Practice address

1000 Medical Center Blvd
Lawrenceville, GA 30046-0000

Phone

(770) 277-3056

Fax

(855) 204-5244

NPI assigned

Jan 22, 2014

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

University of Alabama School of Medicine, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Mak Anesthesia Georgia, LLCGroup PAC ID 7315203718, 108 clinicians

Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mak Anesthesia Georgia, LLC

  • Anesthesiology Physician
  • Kennesaw, GA
  • NPI 1609390103
  Medicare reassignment Care Compare group NPD
• Mak Anesthesia Holdings LLC

  • Anesthesiology Physician
  • Kennesaw, GA
  • NPI 1912452939
  Medicare reassignment Care Compare group NPD
• Advanced Gynecology PC

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Watkinsville, GA
  • NPI 1093296824
  Medicare reassignment NPD
• Advanced Urology Anesthesia, LLC

  • Specialist
  • Snellville, GA
  • NPI 1215365242
  Medicare reassignment NPD
• Advanced Urology Institute of Georgia

  • Urology Physician
  • Snellville, GA
  • NPI 1073896510
  Medicare reassignment NPD
• American Anesthesiology Associates of Georgia, LLC

  • Anesthesiology Physician
  • Stone Mountain, GA
  • NPI 1528068673
  Medicare reassignment NPD
• Advanced Gynecology PC

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Atlanta, GA
  • NPI 1063095081
  NPD
• Advanced Urology Institute of Georgia PC

  • Urology Physician
  • Canton, GA
  • NPI 1942820576
  NPD
• Advanced Urology Institute of Georgia, PC

  • Urology Physician
  • Dallas, GA
  • NPI 1811846348
  NPD
• Astra Plastic Surgery, LLC

  • Plastic and Reconstructive Surgery Physician
  • Alpharetta, GA
  • NPI 1992063606
  NPD (past)

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1295158541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "954-839-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300460000",
            "telephone_number": "770-277-3056",
            "fax_number": "855-204-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKERSON",
        "first_name": "AMANDA",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN159328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003143008A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Hetzler, DPT
• Kristen Roach Heuerman, APRN, CNM
• Leonie Tamara Hewling, LPN
• Henok Heyes
• Hi-Hope Service Center
• Emma Hickey
• Katie Michel Hickman, PA-C
• Lindsay Hickman
• Michaela Hicks
• Robert Hicks, F.N.P.

• Certified Registered Nurse Anesthetist in Lawrenceville, GA
• Providers in Lawrenceville, 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 Apr 14, 2014; 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.