Individual provider Active NPI

Matthew Nesmith

  • Certified Registered Nurse Anesthetist
  • Saint Marys, GA
National Provider Identifier
1427452002
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN195470 Issued in GA
Practice address
2000 Dan Proctor Dr
Saint Marys, GA 31558-3810
Phone
(912) 576-6140
NPI assigned
Oct 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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 RN195470 GA Primary

Addresses

Primary practice location

2000 Dan Proctor Dr
Saint Marys, GA 31558-3810

Mailing address

1497 Fair Rd 102
Statesboro, GA 30458-0823
Phone (912) 486-1973

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150102000871 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052634771 Reassigns benefits to 2 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
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

  • East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN195470GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ams Southeast LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2017 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Mar 16, 2016 Accepting new patients
East Georgia Hma Physician Management, LLC PastSince Feb 17, 2010 Accepting new patients

Locations

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

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

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

Organizations & group practices 3

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": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1427452002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1497 FAIR RD 102",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580823",
            "telephone_number": "912-486-1973",
            "fax_number": "912-681-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 DAN PROCTOR DR",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583810",
            "telephone_number": "912-576-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESMITH",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-10",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN195470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.