NPIMap

Organization Active NPI

WGG Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Carrollton, GA
National Provider Identifier
1578843280
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
WGG ANESTHESIA, LLC
Practice address
160 Clinic Ave
Carrollton, GA 30117-4451
Phone
(770) 214-2800
NPI assigned
Aug 25, 2011
Last updated
Mar 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Authorized official

Name
Jim Cooley
Title
Practice Manager
Phone
(770) 214-2800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

160 Clinic Ave
Carrollton, GA 30117-4451

Mailing address

PO Box 4860
Murrells Inlet, SC 29576-2698
Phone (843) 651-2624

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110915000641 GA Part B Supplier - Clinic/Group Practice 4981875325 Receives reassigned benefits from 43 practitioners
Practice locations: Carrollton, GA

National Provider Directory

National Provider Directory

Locations

157 Clinic Ave
Ste 201
Carrollton, GA 30117
Phone (770) 214-2800

Practitioners & affiliated clinicians

Practitioners 44

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 44

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1578843280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4860",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295762698",
            "telephone_number": "843-651-2624",
            "fax_number": "843-357-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CLINIC AVE",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174451",
            "telephone_number": "770-214-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WGG ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "COOLEY",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "770-214-2800"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.