Mitchael Lee Vickers, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN141647 Issued in GA

Practice address

2500 Hospital Blvd
Suite 480
Roswell, GA 30076-4975

Phone

(678) 762-0676

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18187/brand/1/csg/1/fhir/r4

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.

• Coastal Ambulatory Anesthesia LLC

  • Anesthesiology Physician
  • Savannah, GA
  • NPI 1750753786
  Medicare reassignment NPD
• Concordia Anesthesiology, Inc

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1619296464
  Medicare reassignment NPD
• Gi Anesthesia of Georgia LLC

  • Certified Registered Nurse Anesthetist
  • Gainesville, GA
  • NPI 1326569187

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Greater Atlanta Anesthesia, LLC

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1285043158
  Medicare reassignment NPD
• RG Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Rome, GA
  • NPI 1235553421

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• SG Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Lawrenceville, GA
  • NPI 1053750646

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Sleep Ezzy

  • Pain Medicine (Anesthesiology) Physician
  • Lawrenceville, GA
  • NPI 1154852820
  Medicare reassignment NPD
• Southcare Anesthesia Services, LLC

  • Anesthesiology Physician
  • Austell, GA
  • NPI 1942713326
  Medicare reassignment NPD
• Anesthesia Consultants of Georgia, LLC

  • Specialist
  • Lithonia, GA
  • NPI 1760752430
  NPD
• JC Anesthesia LLC

  • Anesthesiology Physician
  • Johns Creek, GA
  • NPI 1821501206
  NPD
• Ahp of Central Georgia, PC

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1972638047

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Georgia Interventional Pain - D LLC

  • Ambulatory Surgical Clinic/Center
  • Decatur, GA
  • NPI 1043660442
  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1437128857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 MAYFIELD RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091552",
            "telephone_number": "678-763-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD",
            "address_2": "SUITE 480",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764975",
            "telephone_number": "678-762-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "MITCHAEL",
        "middle_name": "LEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN141647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00232387",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000806242M",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James George Velimesis, MD
• Claudia J Vellozzi, MD
• Andrea Johnson Verburg, LPMT, MT-BC
• Veriswound
• Vibrant ABA of Georgia LLC
• Bakari Eugene Vickerson, M.D.
• Vida Brain Center
• Vida Chiropractic Center
• Tarreonne Vilera, RBT
• Desiree Villadolid, M.D.

• Certified Registered Nurse Anesthetist in Roswell, GA
• Providers in Roswell, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.