Individual provider Active NPI

Anthony Travis Pemerton, CRNA

  • Certified Registered Nurse Anesthetist
  • Rome, GA
National Provider Identifier
1598752685
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN-CRNA116161 Issued in GA
Practice address
1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone
(706) 234-5651
Fax
(706) 234-5651
NPI assigned
Oct 4, 2005
Last updated
Oct 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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 APRN-CRNA116161 GA Primary

Addresses

Primary practice location

1825 Martha Berry Blvd NW
Rome, GA 30165-1625

Mailing address

110 Valley Brook Dr SE
Rome, GA 30161-5966
Phone (706) 234-5651

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050601000888 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517909484 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-CRNA116161GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC CurrentSince Apr 1, 2022 Accepting new patients
Preferred Anesthesia Consultants LLC Past Accepting new patients
Harbin Clinic, LLC Past Accepting new patients

Locations

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865

Organizations & group practices 3

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1598752685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 VALLEY BROOK DR SE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301615966",
            "telephone_number": "706-234-5651",
            "fax_number": "706-234-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651625",
            "telephone_number": "706-234-5651",
            "fax_number": "706-234-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMERTON",
        "first_name": "ANTHONY",
        "middle_name": "TRAVIS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "APRN-CRNA116161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; 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.