Dustin Connell, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN167296 Issued in GA

Practice address

901 18TH St E
Tifton, GA 31794-3648

Phone

(229) 353-6124

Fax

(229) 353-7722

NPI assigned

May 10, 2012

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 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ams Southeast LLCGroup PAC ID 3870880792, 83 clinicians

Ear, Nose, and Throat Clinic of Coffee Co.Group PAC ID 4486698578, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ear, Nose and Throat Clinic of Coffee Co.

  • Specialist
  • Douglas, GA
  • NPI 1891750774
  Medicare reassignment Care Compare group NPD
• Lala Land Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Tifton, GA
  • NPI 1093242422

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD Authorized official
• Ams Southeast LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1487107157

  GA

  Medicare reassignment Care Compare group
• Guardian Medical Services, LLC

  • Certified Registered Nurse Anesthetist
  • Macon, GA
  • NPI 1255786521

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Irwin County Anesthesia, Inc.

  • Certified Registered Nurse Anesthetist
  • Ocilla, GA
  • NPI 1275754103

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Irwin County Hospital

  • Rural Acute Care Hospital
  • Ocilla, GA
  • NPI 1720098791
  Medicare reassignment NPD
• Sentry Anesthesia Management, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1134544794
  Medicare reassignment
• Westside Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Douglas, GA
  • NPI 1013158948
  NPD (past)

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495065600000",
    "number": "1306105390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 BELFLOWER RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941607",
            "telephone_number": "229-392-8840",
            "fax_number": "478-333-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "229-353-6124",
            "fax_number": "229-353-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "DUSTIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2017-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN167296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "RN167296",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Clifton, CRNA
• Troy A Clifton, MD
• Amanda L Cofield, LCSW
• Shelley Colwell, FNP
• Complete Neuro, LLC
• Spencer Michael Connell, FNP-BC
• Joann Goff Cook, APRN WHNP BC
• Amber Cooper
• Copeland Health Services, Inc.
• Albert D Copeland Jr., M.D.

• Certified Registered Nurse Anesthetist in Tifton, GA
• Providers in Tifton, 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 May 18, 2017; 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.