Individual provider Active NPI

Samuel W Jones, CRNA

  • Certified Registered Nurse Anesthetist
  • Atlanta, GA
National Provider Identifier
1609241538
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
GA-CRNA001081 Issued in GA
Practice address
1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone
(678) 216-0771
NPI assigned
Dec 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001231147 VA
Certified Registered Nurse Anesthetist 367500000X C-APN.0003966-C-CRNA CO
Certified Registered Nurse Anesthetist 367500000X GA-CRNA001081 GA Primary

Addresses

Primary practice location

1968 Peachtree Rd NW
Atlanta, GA 30309-1281

Mailing address

10800 Midlothian Tpke
North Chesterfield, VA 23235-4724
Phone (804) 594-2622

Other practice location 1

10800 Midlothian Tpke
North Chesterfield, VA 23235-4724
Phone (804) 594-2622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160421001884 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901105105 Reassigns benefits to 2 organizations
I20221110000541 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901105105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dogwood Anesthesia Providers LLCGroup PAC ID 2769853084, 141 clinicians

Practice addresses (Care Compare)

7101 Jahnke Rd
Richmond, VA 23225-4017
Phone (804) 483-0817

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0001231147VAMDRegistered Nurse
C-APN.0003966-C-CRNACOMDCertified Registered Nurse Anesthetist
GA-CRNA001081GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dogwood Anesthesia Providers, LLC CurrentSince Jun 4, 2024 Accepting new patients
Piedmont Anesthesia Associates, L.L.C CurrentSince Oct 1, 2022 Accepting new patients
Commonwealth Anesthesia Associates, P.C. CurrentSince Mar 3, 2016 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

10800 Midlothian Tpke
Ste 265
North Chesterfield, VA 23235
Phone (804) 594-1383

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1609241538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 MIDLOTHIAN TPKE",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354724",
            "telephone_number": "804-594-2622",
            "fax_number": "804-594-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "678-216-0771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 Midlothian Tpke",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232354724",
            "country_code": "US",
            "telephone_number": "804-594-2622",
            "fax_number": "804-594-0915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "SAMUEL",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-03",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001231147",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "C-APN.0003966-C-CRNA",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "GA-CRNA001081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.