James A Joseph, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Lavonia, GA

NPI 1598801524 · NPPES record last updated Dec 16, 2015

Key facts

NPI
1598801524
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
RN079744 (GA)
Practice address
367 Clear Creek Pkwy
Lavonia, GA 30553-4173
Phone
(706) 356-7800
Fax
(706) 567-6036
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
RN079744GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ty Cobb Healthcare System, Inc Past Accepting new patients
Ty Cobb Healthcare System Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN079744 GA Yes

Addresses

Primary practice location

367 Clear Creek Pkwy
Lavonia, GA 30553-4173

Mailing address

4523 Highway 246 N
Hodges, SC 29653-9705
Phone (864) 374-7363

Other identifiers

IdentifierTypeStateIssuer
025919180EMedicaidGA
025919180FMedicaidGA
025919810AMedicaidGA
025919180BMedicaidGA

Other providers in Lavonia, GA

All providers in Lavonia, GA · Certified Registered Nurse Anesthetist in Georgia

Sources for this page

Verify at the official NPI Registry.