NPIMap

Organization Active NPI

Ambulatory Anesthesia of North Georgia, LLC

  • Anesthesiology Physician
  • Gainesville, GA
National Provider Identifier
1497870562
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
AMBULATORY ANESTHESIA OF NORTH GEORGIA, LLC
Practice address
1488 Jesse Jewell Pkwy SE
Suite 100
Gainesville, GA 30501-3803
Phone
(770) 532-7179
Fax
(770) 534-1312
NPI assigned
Mar 20, 2007
Last updated
May 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Authorized official

Name
Mrs. Teena Stinespring
Title
Credentialing Coordinator
Phone
(770) 532-7179

Specialties & licenses 1

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

Addresses

Primary practice location

1488 Jesse Jewell Pkwy SE
Suite 100
Gainesville, GA 30501-3803

Mailing address

1488 Jesse Jewell Pkwy SE Ste 100
Gainesville, GA 30501-3804
Phone (770) 532-7179

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051229000181 GA Part B Supplier - Clinic/Group Practice 9931121332 Receives reassigned benefits from 159 practitioners
Practice locations: Gainesville, GA

National Provider Directory

National Provider Directory

Locations

1240 Jesse Jewell Pkwy SE
Ste 250
Gainesville, GA 30501
Phone (678) 541-5552

Practitioners & affiliated clinicians

Practitioners 190

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 190

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588636800000",
    "number": "1497870562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 JESSE JEWELL PKWY SE STE 100",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013804",
            "telephone_number": "770-532-7179",
            "fax_number": "770-534-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 100",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013803",
            "telephone_number": "770-532-7179",
            "fax_number": "770-534-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY ANESTHESIA OF NORTH GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "STINESPRING",
        "authorized_official_first_name": "TEENA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "770-532-7179",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.