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
Last updated
Mar 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

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

Mailing address

PO Box 4380
Alpharetta, GA 30023-4380

Medicare participation

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

Enrollment records 1

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

1111 Glynco Pkwy
Ste 300
Brunswick, GA 31525
Phone (912) 262-6552

88 Martin Luther King Jr Dr
#D
Forsyth, GA 31029
Phone (419) 994-2521

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

615 S Hansell St
Thomasville, GA 31792
Phone (229) 226-2234

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "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.