Individual provider Active NPI

Denise Woodall, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Snellville, GA
National Provider Identifier
1558343269
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN139540 Issued in GA
Practice address
2151 Fountain Dr
Suite 101
Snellville, GA 30078-6783
Phone
(770) 979-9996
NPI assigned
Nov 17, 2005
Last updated
Oct 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN139540 GA Primary

Addresses

Primary practice location

2151 Fountain Dr
Suite 101
Snellville, GA 30078-6783

Mailing address

PO Box 525
Snellville, GA 30078-0525
Phone (770) 979-9996

Other identifiers 1

IdentifierTypeStateIssuer
197715386AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040503000261 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709874530 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN139540GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Consultants of Athens CurrentSince May 1, 2005 Accepting new patients
North Fulton Anesthesia Associates PC Nurse Anesthetist, Certified Registered CurrentSince Jun 30, 2022 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Aug 1, 2015 Accepting new patients
New London Anesthesia & Pain Consultants PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1500 Oglethorpe Ave
Ste 2100
Athens, GA 30606
Phone (706) 425-5437

651 S Milledge Ave
Athens, GA 30605
Phone (706) 546-9290

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

2151 Peachford Rd
Dunwoody, GA 30338
Phone (770) 313-2034

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

Organizations & group practices 4

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1558343269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 525",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300780525",
            "telephone_number": "770-979-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 FOUNTAIN DR",
            "address_2": "SUITE 101",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786783",
            "telephone_number": "770-979-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "DENISE",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN139540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197715386A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.