Individual provider Active NPI

Kory Sutter, PA AA

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1346333531
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
004888 Issued in GA
Practice address
303 Parkway Dr NE
PMB 404
Atlanta, GA 30312-1212
Phone
(404) 265-4520
Fax
(404) 265-3894
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 004888 GA Primary

Addresses

Primary practice location

303 Parkway Dr NE
PMB 404
Atlanta, GA 30312-1212

Mailing address

PO Box 932925
Atlanta, GA 31193-2925
Phone (800) 364-9216

Other identifiers 2

IdentifierTypeStateIssuer
460363393AMedicaidGA
P00353078OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071121000232 GA Practitioner - Anesthesiology Assistant 9032119052 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
004888GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mak Anesthesia Holdings LLC CurrentSince Nov 28, 2018 Accepting new patients
Emory Specialty Associates, LLC CurrentSince Oct 1, 2022 Accepting new patients
Piedmont Anesthesia Associates, L.L.C CurrentSince May 1, 2014 Accepting new patients
The Emory Clinic Inc CurrentSince Jul 4, 2023 Accepting new patients

Locations

303 Parkway Dr NE
Atlanta, GA 30312
Phone (404) 265-4000

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

1491 Montreal Rd
Tucker, GA 30084
Phone (770) 270-1284

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1346333531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932925",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932925",
            "telephone_number": "800-364-9216",
            "fax_number": "423-892-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PARKWAY DR NE",
            "address_2": "PMB 404",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121212",
            "telephone_number": "404-265-4520",
            "fax_number": "404-265-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTER",
        "first_name": "KORY",
        "credential": "PA AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "004888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "460363393A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00353078",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.