Individual provider Active NPI

Marche D Jenkins, CRNA

  • Certified Registered Nurse Anesthetist
  • Roswell, GA
National Provider Identifier
1568442010
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
148720 Issued in NC
Practice address
1390 Bellsmith Dr
Roswell, GA 30076-0916
Phone
(770) 521-7509
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 148720 NC Primary
Certified Registered Nurse Anesthetist 367500000X RN180094 CRNA GA

Addresses

Primary practice location

1390 Bellsmith Dr
Roswell, GA 30076-0916

Mailing address

1390 Bellsmith Dr
Roswell, GA 30076-0916
Phone (770) 521-7509

Other identifiers 1

IdentifierTypeStateIssuer
8051448MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060320000381 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173428745 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN180094 CRNAGAMDCertified Registered Nurse Anesthetist
148720NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Concordia Anesthesiology, Inc CurrentSince Mar 30, 2022 Accepting new patients
Anesthesia Professionals Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 9, 2025 Accepting new patients
Ahp of Central Georgia, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
North Fulton OB-GYN, P.C. Past Accepting new patients
Mercy Hospital, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Ahp of Georgia, LLC Nurse Anesthetist, Certified Registered PastSince Aug 1, 2004 Accepting new patients

Locations

11975 Morris Rd
Ste 310B
Alpharetta, GA 30005
Phone (770) 754-4445

11975 Morris Rd
Ste 31B
Alpharetta, GA 30005

2678 Buford Hwy NE
Atlanta, GA 30324
Phone (678) 500-1066

494 Boulevard SE
Atlanta, GA 30312
Phone (404) 607-1002

550 Peachtree St NE
Ste 1220
Atlanta, GA 30308
Phone (404) 230-5622

1800 Peachtree St NW
Ste 640
Atlanta, GA 30309
Phone (404) 370-1817

1790 Mulkey Rd
Ste 9A
Austell, GA 30106
Phone (770) 739-1200

1403 Manchester Dr NE
Conyers, GA 30012
Phone (770) 760-8484

755 Commerce Dr
Ste 300
Decatur, GA 30030
Phone (404) 593-2739

3635 Peachtree Industrial Blvd
Ste 150
Duluth, GA 30096
Phone (678) 474-1115

10475 Medlock Bridge Rd
Ste 810
Johns Creek, GA 30097
Phone (470) 771-2436

6290 Abbotts Bridge Rd
Ste 201
Johns Creek, GA 30097
Phone (470) 395-4871

1595 Kennesaw Due West Rd NW
Ste 100
Kennesaw, GA 30152
Phone (470) 308-3365

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

11650 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 543-8132

3200 Highlands Pkwy SE
Ste 420
Smyrna, GA 30082
Phone (678) 424-1123

2685 Peachtree Pkwy
Ste 300
Suwanee, GA 30024
Phone (770) 771-5260

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8406/brand/1/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1568442010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 BELLSMITH DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300760916",
            "telephone_number": "770-521-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 BELLSMITH DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300760916",
            "telephone_number": "770-521-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MARCHE",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "148720",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN180094 CRNA",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051448",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.