Active NPI
Ronaldo E. Mabini, CRNA
- Certified Registered Nurse Anesthetist
- Atlanta, GA
National Provider Identifier
1457347189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN062781
- Practice address
- 1000 Johnson Ferry Rd
Atlanta, GA 30342 - Phone
- (770) 645-9181
- Fax
- (770) 645-8455
- NPI assigned
- Sep 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN062781 | GA | Primary |
Addresses
Primary practice location
1000 Johnson Ferry Rd
Atlanta, GA 30342
Mailing address
3155 N Point Pkwy
Attn: Credentialing Dept., Building F, Suite 100
Alpharetta, GA 30005
Phone (770) 645-9181
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000550096C | Medicaid | GA | |
| 000550096A | Medicaid | GA | |
| 000550096D | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN062781 | GA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northside Cherokee Anesthesia Consultants, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Canton, GA
- NPI 1144299629
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1457347189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3155 N POINT PKWY",
"address_2": "ATTN: CREDENTIALING DEPT., BUILDING F, SUITE 100",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "30005",
"telephone_number": "770-645-9181",
"fax_number": "770-645-8455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 JOHNSON FERRY RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30342",
"telephone_number": "770-645-9181",
"fax_number": "770-645-8455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABINI",
"first_name": "RONALDO",
"middle_name": "E.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "GA",
"license": "RN062781",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000550096C",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000550096A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000550096D",
"state": "GA"
}
],
"endpoints": [],
"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 Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.