Grant Adam Doornbos, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

069398 Issued in GA

Practice address

1300 Ridenour Blvd NW Ste 300
Kennesaw, GA 30152-4402

Phone

(770) 702-1806

NPI assigned

Apr 1, 2009

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Mak Anesthesia Holdings LLC

  • Anesthesiology Physician
  • Kennesaw, GA
  • NPI 1912452939
  Medicare reassignment Care Compare group NPD
• Fortis Health, LLC

  • Anesthesiology Physician
  • Jasper, GA
  • NPI 1659960276
  Medicare reassignment NPD
• Mak Anesthesia Cobb LLC

  • Anesthesiology Physician
  • Austell, GA
  • NPI 1699045070
  NPD (past)

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

• Cobb Hospital, Inc

  dba Wellstar Cobb Hospital

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1376785600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 GLENGARRY WAY NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752615",
            "telephone_number": "404-245-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 RIDENOUR BLVD NW STE 300",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524402",
            "telephone_number": "770-702-1806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2595 Ridgewood Terrace NW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30318",
            "country_code": "US",
            "telephone_number": "404-245-3687",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4441 Atlanta Rd SE",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "300806406",
            "country_code": "US",
            "telephone_number": "770-702-1806 x210",
            "fax_number": "770-693-0810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOORNBOS",
        "first_name": "GRANT",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "069398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristopher Dolehanty, PA-C
• Elisabeth Dolloff
• Caroline Nicole Donner, NP-C
• India Donofrio, OD
• Taniah Doomes, RBT
• Marie Carline Dorleus, FNP
• Kate Dorrough, LPC
• Sonny Sandeep Singh Dosanjh, MD
• Douglas J. Deuchar, D.M.D., P.C.
• Paul Christopher Dozier, CRNA

• Anesthesiology Physician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Anesthesiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.