Individual provider Active NPI

Kimberly Kimble Rodriguez, CRNA

  • Certified Registered Nurse Anesthetist
  • Atlanta, GA
National Provider Identifier
1427448471
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
198249 Issued in GA
Practice address
1984 Peachtree Rd NW
#515
Atlanta, GA 30309-5219
Phone
(404) 351-1745
NPI assigned
Jan 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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 198249 GA Primary

Addresses

Primary practice location

1984 Peachtree Rd NW
#515
Atlanta, GA 30309-5219

Mailing address

PO Box 117535
Atlanta, GA 30368-7535

Other names 1

  • Kimberly Kimble Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150427000737 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850610734 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
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)

1350 Walton Way
Augusta, GA 30901-2612
Phone (478) 746-7577

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
198249GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 17, 2018 Accepting new patients
Piedmont Anesthesia LLC CurrentSince Oct 9, 2022 Accepting new patients
Au Medical Associates Anesthesia Billing Services, LLC CurrentSince Feb 11, 2019 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Nov 14, 2022 Accepting new patients
Anesthesia and Pain Medicine Past Accepting new patients

Locations

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

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

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

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

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

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

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 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": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1427448471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117535",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303687535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1984 PEACHTREE RD NW",
            "address_2": "#515",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303095219",
            "telephone_number": "404-351-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KIMBERLY",
        "middle_name": "KIMBLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "198249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "KIMBLE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 22, 2024; 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.