Individual provider Active NPI

Dwight A Kingry, CRNA

  • Certified Registered Nurse Anesthetist
  • Atlanta, GA
National Provider Identifier
1386649937
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN166317 Issued in GA
Practice address
1968 Peachtree Rd. NW
Atlanta, GA 30309-1281
Phone
(404) 351-1745
Fax
(404) 351-7121
NPI assigned
Jun 19, 2005
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN166317 GA Primary
Certified Registered Nurse Anesthetist 367500000X APN0000010813 TN

Addresses

Primary practice location

1968 Peachtree Rd. NW
Atlanta, GA 30309-1281

Mailing address

PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040507001282 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365431053 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians
Mak Anesthesia Georgia, LLCGroup PAC ID 7315203718, 108 clinicians

Practice addresses (Care Compare)

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

2306 Wisteria Dr
Suite 100
Snellville, GA 30078-3561
Phone (770) 979-8200

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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
53481TNMDPediatric Anesthesiology Physician
RN166317GAMDCertified Registered Nurse Anesthetist
APN0000010813TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC CurrentSince Dec 1, 2013 Accepting new patients
North Fulton Anesthesia Associates PC Nurse Anesthetist, Certified Registered CurrentSince Nov 10, 2013 Accepting new patients
Mak Anesthesia Georgia, LLC CurrentSince Nov 1, 2025 Accepting new patients
Gastrointestinal Specialist of Georgia CurrentSince Jan 20, 2023 Accepting new patients
Mak Anesthesia Holdings LLC CurrentSince Nov 17, 2018 Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients

Locations

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

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

2151 Peachford Rd
Dunwoody, GA 30338
Phone (770) 313-2034

711 Canton Rd NE
Ste 300
Marietta, GA 30060
Phone (678) 741-2317

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

5995 Barfield Rd
Sandy Springs, GA 30328
Phone (404) 256-1507

2131 Fountain Dr
Snellville, GA 30078
Phone (770) 979-8200

2306 Wisteria Dr
Ste 100
Snellville, GA 30078
Phone (770) 979-8200

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1386649937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "954-839-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD. NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "404-351-1745",
            "fax_number": "404-351-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGRY",
        "first_name": "DWIGHT",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-19",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN166317",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN0000010813",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jul 31, 2023; 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.