Individual provider Active NPI

John Braxton Redding, CRNA

  • Certified Registered Nurse Anesthetist
  • Statesboro, GA
National Provider Identifier
1407195225
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN195323 Issued in GA
Practice address
1499 Fair Rd
Statesboro, GA 30458-1683
Phone
(912) 486-1973
Fax
(912) 681-4184
NPI assigned
Feb 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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 RN195323 GA Primary

Addresses

Primary practice location

1499 Fair Rd
Statesboro, GA 30458-1683

Mailing address

PO Box 73709
Newnan, GA 30271-3709
Phone (770) 251-2060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130507000503 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810134012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams Southeast LLCGroup PAC ID 3870880792, 83 clinicians

Practice addresses (Care Compare)

1499 Fair Rd
Statesboro, GA 30458-1683
Phone (912) 486-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN195323GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ams Southeast LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2017 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Feb 12, 2018 Accepting new patients

Locations

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

200 N River St
Claxton, GA 30417
Phone (912) 739-2611

400 Cedar St
Metter, GA 30439
Phone (912) 685-1726

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1407195225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73709",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302713709",
            "telephone_number": "770-251-2060",
            "fax_number": "678-854-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 FAIR RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581683",
            "telephone_number": "912-486-1973",
            "fax_number": "912-681-4184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDING",
        "first_name": "JOHN",
        "middle_name": "BRAXTON",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-14",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN195323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.