Individual provider Active NPI

Dominique Daielle Peart, CRNA

  • Certified Registered Nurse Anesthetist
  • Lawrenceville, GA
National Provider Identifier
1578067179
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
207725 Issued in GA
Practice address
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone
(678) 312-1000
NPI assigned
Mar 20, 2018
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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 207725 GA Primary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 207725 GA

Addresses

Primary practice location

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Mailing address

4611 Saybrook Dr
Norcross, GA 30093-4741
Phone (229) 395-6524

Other identifiers 1

IdentifierTypeStateIssuer
207725OtherGAGEORGIA SECRETARY OF STATE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180419001731 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890058176 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
207725GAMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 23, 2020 Accepting new patients
Pain Physicians Anesthesia, LLC CurrentSince Oct 2, 2020 Accepting new patients
Walton Anesthesia Associates, PC CurrentSince Feb 2, 2021 Accepting new patients
Gi Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2021 Accepting new patients
Emory Specialty Associates, LLC CurrentSince Jun 14, 2022 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince May 1, 2018 Accepting new patients
Piedmont Anesthesia LLC CurrentSince Feb 28, 2022 Accepting new patients
Coastal Ambulatory Anesthesia LLC CurrentSince Dec 30, 2021 Accepting new patients
Gastroenterology Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

340 N Milledge Ave
Ste A
Athens, GA 30601
Phone (706) 548-0008

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

550 Peachtree St NE
Ste 1600
Atlanta, GA 30308
Phone (404) 881-1094

1515 River Pl
Ste 320
Braselton, GA 30517
Phone (678) 997-2125

2675 N Decatur Rd
Ste 506
Decatur, GA 30033
Phone (404) 299-1679

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

8855 Hospital Dr
Ste 102
Douglasville, GA 30134
Phone (678) 784-5020

1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499

2324 Limestone Overlook
Ste 200
Gainesville, GA 30501
Phone (312) 724-7441

226 E College St
#A
Griffin, GA 30224
Phone (678) 987-1490

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

301 Philip Blvd
Ste B
Lawrenceville, GA 30046
Phone (770) 682-7220

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

488 Kennesaw Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 427-3075

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

34 Upper Riverdale Rd SE
Ste 201
Riverdale, GA 30274
Phone (678) 904-0094

5671 Ptree Dunwoody Rd NE
Ste 680
Sandy Springs, GA 30342
Phone (404) 705-6985

1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

150 N Park Trl
#A
Stockbridge, GA 30281
Phone (770) 507-0909

1360 Caduceus Way
Bldg 300
Watkinsville, GA 30677
Phone (706) 850-4985

900 Towne Lake Pkwy
Ste 310
Woodstock, GA 30189
Phone (770) 926-0071

Organizations & group practices 9

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1578067179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 SAYBROOK DR",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300934741",
            "telephone_number": "229-395-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "678-312-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEART",
        "first_name": "DOMINIQUE",
        "middle_name": "DAIELLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "207725",
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "GA",
            "license": "207725",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA SECRETARY OF STATE",
            "identifier": "207725",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.