NPIMap

Organization Active NPI

Eminence Anesthesia LLC

  • Anesthesiology Physician
  • Forsyth, GA
National Provider Identifier
1497219240
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
EMINENCE ANESTHESIA LLC
Practice address
88 Martin Luther King Jr Dr
Forsyth, GA 31029-1682
Phone
(888) 728-0882
NPI assigned
Jan 25, 2019
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Kirby Kitchens
Title
Owner
Phone
(888) 728-0882

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 37

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20240311002052 GA Part B Supplier - Clinic/Group Practice 6406260553 Receives reassigned benefits from 14 practitioners
Practice locations: Hawkinsville, GA; Jesup, GA; Johns Creek, GA; Macon, GA; Marietta, GA; Savannah, GA; Statesboro, GA; Stockbridge, GA…

National Provider Directory

National Provider Directory

Locations

308 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 426-2565

414 5th Ave
Albany, GA 31701
Phone (229) 432-9515

2709 Meredyth Dr
Ste 210
Albany, GA 31707
Phone (229) 432-7012

312 Westside Dr
Douglas, GA 31533
Phone 9123842200222

425 Forest Pkwy
Ste 103
Forest Park, GA 30297
Phone (404) 363-1087

215 Sheraton Blvd
Ste 200
Macon, GA 31210
Phone (478) 757-8868

3294 N Oak Street Ext
Valdosta, GA 31605
Phone (229) 241-1188

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

88 Martin Luther King Jr Dr
Forsyth, GA 31029-1682

Mailing address

PO Box 4380
Alpharetta, GA 30023-4380

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 5, 2024.

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1497219240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4380",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300234380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 MARTIN LUTHER KING JR DR",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310291682",
            "telephone_number": "888-728-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMINENCE ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-25",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "KITCHENS",
        "authorized_official_first_name": "KIRBY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-728-0882",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forsyth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.