Individual provider Active NPI

Maria Magdalena Earnhart

  • Anesthesiologist Assistant
  • Fayetteville, GA
National Provider Identifier
1477782399
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone
(770) 719-7000
NPI assigned
Jul 13, 2009
Last updated
Jul 13, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

1255 Highway 54 W
Fayetteville, GA 30214-4526

Mailing address

524 Akers Ridge Dr SE
Atlanta, GA 30339-3217
Phone (770) 595-8851

Other names 1

  • Miss Maria Magdalena Allegra Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091117000033 GA Practitioner - Anesthesiology Assistant 1456498724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Mak Anesthesia Georgia, LLCGroup PAC ID 7315203718, 108 clinicians
Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Practice addresses (Care Compare)

5995 Barfield Rd
Sandy Springs, GA 30328-4411
Phone 7707021806210

895 Canton Rd NE
Suite 300
Marietta, GA 30060-8934
Phone 7707021806209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
1904GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mak Anesthesia Georgia, LLC CurrentSince May 1, 2019 Accepting new patients
Mak Anesthesia Holdings LLC CurrentSince Jan 30, 2017 Accepting new patients
Piedmont Anesthesia Associates, L.L.C Past Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1457 Scott Blvd
Decatur, GA 30030
Phone (404) 292-2500

1635 Old Highway 41 NW
Ste 112328
Kennesaw, GA 30152
Phone (770) 732-3664

2550 Windy Hill Rd SE
Ste 218
Marietta, GA 30067
Phone (770) 933-1900

895 Canton Rd NE
Bldg 200
Marietta, GA 30060
Phone (678) 784-0203

5995 Barfield Rd
Sandy Springs, GA 30328
Phone (404) 256-1507

2131 Fountain Dr
Snellville, GA 30078
Phone (770) 979-8200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247443200000",
    "number": "1477782399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 AKERS RIDGE DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393217",
            "telephone_number": "770-595-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144526",
            "telephone_number": "770-719-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARNHART",
        "first_name": "MARIA",
        "middle_name": "MAGDALENA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "ALLEGRA",
            "middle_name": "MAGDALENA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.