Vituity-Georgia Anesthesia PC
Organization Active NPI Anesthesiology Physician · Lavonia, GA
NPI 1356190888 · NPPES record last updated Jul 19, 2024
Key facts
- NPI
- 1356190888
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- VITUITY-GEORGIA ANESTHESIA PC
- Practice address
- 367 Clear Creek Pkwy
Lavonia, GA 30553-4173 - Phone
- (706) 356-7800
- NPI assigned
- May 16, 2024
- Organization subpart
- No
Authorized official
- Name
- Theophile Koury
- Title
- President
- Phone
- (510) 350-2600
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 1
Practitioners 31
-
Danny A Bartlett, CRNA
-
Paula Carroll, CRNA
-
Maxwell Donnan, DNP
-
Ross Ashmore Fuller, CRNA
-
Carlton Guthrie, CRNA
-
Ned W. Hembree, MD
-
Joseph Lawrence, CRNA
-
Raul Anthony Mendiola, M.D.
-
Shaun O'Rear, MD
-
Matthew Olliff, MD
-
Jack Walker Paschal, M.D.
-
Everett Leland Perry, M.D.
-
Wallace Scott Phillips, CRNA
-
Joseph Lee Rawlings, M.D.
-
Donald Ruch, CRNA
-
Brittany L Schmitt, CRNA
-
Dat Phat Vu, MD
-
Tamara Wojciechowski, PHDC, CRNA, FAAPM
-
Frederick D Adams, CRNA
-
Ryan Jackson Corley, M.D.
-
Margaret A. Stark, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241122000383 | GA | Part B Supplier - Clinic/Group Practice | 6901331339 |
Receives reassigned benefits from 31 practitioners 1 other NPI on this enrollment Practice locations: Lavonia, GA; Greensboro, GA |
National Provider Directory
- Tax ID family
- Vituity-Georgia Anesthesia PC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes |
Addresses
Primary practice location
367 Clear Creek Pkwy
Lavonia, GA 30553-4173
Mailing address
2100 Powell St Ste 400
Emeryville, CA 94608-1872
Phone (510) 350-2600
Other providers in Lavonia, GA
- True Health Chiropractic, LLC
- Ty Cobb Healthcare System, Inc.
- Ty Cobb Healthcare System, Inc.
- Ty Cobb Regional Medical Center LLC
- Ty Cobb Regional Medical Center, Inc
- Vituity-Georgia Hospitalists PC
- Walgreen Co
- Jonathan Hugh Weathers
- Richard S White III
- Robert White
All providers in Lavonia, GA · Anesthesiology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.