Active NPI
Michael Aaron Crisp, PAA
- Anesthesiologist Assistant
- Marietta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- 12061
- Practice address
- 2540 Windy Hill Rd SE
Marietta, GA 30067-8605 - Phone
- (470) 644-1274
- NPI assigned
- Apr 17, 2021
- 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 |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 12061 | GA | Primary |
Addresses
Primary practice location
2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Mailing address
2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone (470) 644-1274
Other practice location 1
57 Executive Park S Ste 300
Atlanta, GA 30329-2287
Phone (404) 727-5910
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mcrisp539793@directwellstar.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology Assistant
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 702-1806
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004
677 Church Nest
Marietta, GA 30060-1101
677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585
Hospital & facility affiliations
- Wellstar Kennestone Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients |
Locations
3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
2540 Windy Hill Rd SE
Marietta, GA 30067
Phone (470) 644-1274
3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500
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.
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Anesthesiology Physician
- Kennesaw, GA
- NPI 1912452939
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Marietta, GA
- NPI 1649248626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715904000000",
"number": "1457932899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2540 WINDY HILL RD SE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300678605",
"telephone_number": "470-644-1274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2540 WINDY HILL RD SE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300678605",
"telephone_number": "470-644-1274"
}
],
"practiceLocations": [
{
"address_1": "57 Executive Park S Ste 300",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303292287",
"country_code": "US",
"telephone_number": "404-727-5910",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRISP",
"first_name": "MICHAEL",
"middle_name": "AARON",
"credential": "PAA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-17",
"last_updated": "2024-05-17",
"certification_date": "2024-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "GA",
"license": "12061",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mcrisp539793@directwellstar.org",
"affiliation": "N",
"address_1": "2540 Windy Hill Rd SE",
"city": "Marietta",
"state": "GA",
"country_code": "US",
"postal_code": "300678605",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.