Active NPI
John Lewis Norman, C.R.N.A.
- Certified Registered Nurse Anesthetist
- Moultrie, GA
National Provider Identifier
1376562934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R051263
- Practice address
- 3131 S Main St
Moultrie, GA 31768-6925 - Phone
- (229) 591-9131
- Fax
- (229) 891-9079
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R051263 | GA | Primary |
Addresses
Primary practice location
3131 S Main St
Moultrie, GA 31768-6925
Mailing address
PO Box 3305
Moultrie, GA 31776-3305
Phone (229) 891-9131
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00556685F | Medicaid | GA | |
| 000556685H | Medicaid | GA | |
| 639663690A | Medicaid | GA | |
| R051263 | Other | GA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R051263 | GA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sumter Regional Medical Group, PC | Past | Accepting new patients | |
| Americus & Sumter County Hospital Authority | Past | Accepting new patients | |
| Colquitt Regional Health Incorporated | Past | Accepting new patients | |
| Tifton Anesthesia Associates, P.C. | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Rehabilitation Hospital Unit
- Americus, GA
- NPI 1164517173
-
- Home Health Agency
- Moultrie, GA
- NPI 1558375840
-
- Specialist
- Americus, GA
- NPI 1073685996
-
- Anesthesiology Physician
- Tifton, GA
- NPI 1710964614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227657600000",
"number": "1376562934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3305",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317763305",
"telephone_number": "229-891-9131",
"fax_number": "229-889-1907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 S MAIN ST",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317686925",
"telephone_number": "229-591-9131",
"fax_number": "229-891-9079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORMAN",
"first_name": "JOHN",
"middle_name": "LEWIS",
"credential": "C.R.N.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2008-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "GA",
"license": "R051263",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00556685F",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000556685H",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "639663690A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "R051263",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Moultrie, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.