Individual provider Active NPI

Mary Lillian Nall, CRNA

  • Certified Registered Nurse Anesthetist
  • Warner Robins, GA
National Provider Identifier
1396709606
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN097904 Issued in GA
Practice address
1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone
(478) 329-0051
NPI assigned
Apr 13, 2006
Last updated
Feb 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN097904 GA Primary

Addresses

Primary practice location

1601 Watson Blvd
Warner Robins, GA 31093-3431

Mailing address

PO Box 235019
Montgomery, AL 36123-5019
Phone (334) 279-1450

Other identifiers 2

IdentifierTypeStateIssuer
369270OtherGASTATE MERIT
668512625AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041021000723 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143281295 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robins Anesthesia Services LLCGroup PAC ID 1052207792, 26 clinicians
Guardian Medical Services LLCGroup PAC ID 8325347735, 28 clinicians

Practice addresses (Care Compare)

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 329-0051

1659 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 329-3100

801 W Gordon St
Thomaston, GA 30286-3426
Phone (706) 647-8111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN097904GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Guardian Medical Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2025 Accepting new patients
Irwin County Anesthesia, Inc. Nurse Anesthetist, Certified Registered CurrentSince Feb 3, 2024 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Feb 8, 2025 Accepting new patients
Mak Anesthesia Holdings LLC CurrentSince Nov 4, 2018 Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

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

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

710 N Irwin Ave
Ocilla, GA 31774
Phone (229) 468-3800

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

1948 Old Ocilla Rd
Ste B
Tifton, GA 31794
Phone (229) 386-5222

4100 International Plz
Ste 800
Ft Worth, TX 76109
Phone (855) 373-6862

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1396709606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235019",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235019",
            "telephone_number": "334-279-1450",
            "fax_number": "334-279-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933431",
            "telephone_number": "478-329-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALL",
        "first_name": "MARY",
        "middle_name": "LILLIAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN097904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MERIT",
            "identifier": "369270",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "668512625A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.