Individual provider Active NPI

Nicolette Musarra Puckett, PAA

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1417972001
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
4597 Issued in GA
Practice address
1405 Clifton Rd NE FL 3
Atlanta, GA 30322-1060
Phone
(404) 785-6670
Fax
(404) 785-1362
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 4597 GA Primary

Addresses

Primary practice location

1405 Clifton Rd NE FL 3
Atlanta, GA 30322-1060

Mailing address

1405 Clifton Rd NE FL 3
Atlanta, GA 30322-1060
Phone (404) 785-6670

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000357 GA Practitioner - Anesthesiology Assistant 2567497472 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (800) 242-1131

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 351-1745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Egleston Pediatric Group Current Accepting new patients
Piedmont Anesthesia LLC CurrentSince Mar 1, 2025 Accepting new patients
Children'S Anesthesia Services, LLC Anesthesiologist Assistant CurrentSince May 29, 2022 Accepting new patients
Choa Hospital Based, LLC Anesthesiologist Assistant CurrentSince May 29, 2022 Accepting new patients
Choa Multispecialty, LLC Current Accepting new patients
Fayette Community Anesthesia Past Accepting new patients

Locations

77 Collier Rd NW
Ste 2000
Atlanta, GA 30309
Phone (404) 242-7263

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

1405 Clifton Rd NE
Fl 3
Atlanta, GA 30322
Phone (404) 785-6670

1265 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-7000

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

5445 Meridian Mark Rd
Ste 340
Sandy Springs, GA 30342
Phone (404) 785-5650

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1417972001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE FL 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "404-785-6670",
            "fax_number": "404-785-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE FL 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "404-785-6670",
            "fax_number": "404-785-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "NICOLETTE",
        "middle_name": "MUSARRA",
        "credential": "PAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "4597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1405 Clifton Rd NE Fl 3",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303221060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jun 6, 2022; 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.