Active NPI
Jasmin Jelissa Malloy, CRNA
- Certified Registered Nurse Anesthetist
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- GAA-CRNA001400
- Practice address
- 1968 Peachtree Rd NW
Atlanta, GA 30309-1281 - Phone
- (404) 605-3775
- NPI assigned
- Nov 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 9314734 | FL | |
| Certified Registered Nurse Anesthetist | 367500000X | GAA-CRNA001400 | GA | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 11014374 | FL | |
| Certified Registered Nurse Anesthetist | 367500000X | RN9314734 | GA |
Addresses
Primary practice location
1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Mailing address
1011 NW 187TH Ave
Pembroke Pines, FL 33029-2913
Phone (954) 554-6902
Other practice location 1
3476 S University Dr
Davie, FL 33328-2000
Phone (954) 475-4400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, FL, GA
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1255 Hwy 54 W
Fayetteville, GA 30214
Phone (770) 719-7000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9314734 | FL | MD | General Practice Registered Nurse |
| 11014374 | FL | MD | Certified Registered Nurse Anesthetist |
| RN9314734 | GA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Illinois, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Piedmont Anesthesia LLC | Current | Accepting new patients | |
| Piedmont Anesthesia Associates, L.L.C | Current | Accepting new patients |
Locations
1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222
1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754
1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911
1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000
20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857
1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
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.
-
- Anesthesiology Physician
- Stockbridge, GA
- NPI 1700474244
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1407856594
-
- Anesthesiology Physician
- Arlington, TX
- NPI 1962822395
IL, Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1962461681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1457893489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 NW 187TH AVE",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330292913",
"telephone_number": "954-554-6902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1968 PEACHTREE RD NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303091281",
"telephone_number": "404-605-3775"
}
],
"practiceLocations": [
{
"address_1": "3476 S University Dr",
"address_purpose": "LOCATION",
"city": "Davie",
"state": "FL",
"postal_code": "333282000",
"country_code": "US",
"telephone_number": "954-475-4400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALLOY",
"first_name": "JASMIN",
"middle_name": "JELISSA",
"name_prefix": "Ms.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-08",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "FL",
"license": "9314734",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "GA",
"license": "GAA-CRNA001400",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "FL",
"license": "11014374",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "GA",
"license": "RN9314734",
"primary": false
}
],
"identifiers": [],
"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 Aug 11, 2026; 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.