Individual provider Active NPI

Jessica Ann McCabe, DO

  • Anesthesiology Physician
  • Johns Creek, GA
National Provider Identifier
1497767131
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
061494 Issued in GA
Practice address
6325 Hospital Pkwy
Suite 111
Johns Creek, GA 30097-5775
Phone
(770) 712-4616
Fax
(770) 495-1585
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 200200737 NC
Anesthesiology Physician 207L00000X 061494 GA Primary

Addresses

Primary practice location

6325 Hospital Pkwy
Suite 111
Johns Creek, GA 30097-5775

Mailing address

6325 Hospital Pkwy
Suite 111
Johns Creek, GA 30097-5775
Phone (770) 712-4616

Other identifiers 1

IdentifierTypeStateIssuer
89132GMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
200200737NCMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1497767131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6325 HOSPITAL PKWY",
            "address_2": "SUITE 111",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300975775",
            "telephone_number": "770-712-4616",
            "fax_number": "770-495-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 HOSPITAL PKWY",
            "address_2": "SUITE 111",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300975775",
            "telephone_number": "770-712-4616",
            "fax_number": "770-495-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCABE",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "200200737",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "061494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89132G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.