NPIMap

Organization Active NPI

Mak Anesthesia Georgia, LLC

  • Anesthesiology Physician
  • Kennesaw, GA
National Provider Identifier
1609390103
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MAK ANESTHESIA GEORGIA, LLC
Practice address
1300 Ridenour Blvd NW Ste 300
Kennesaw, GA 30152-4402
Phone
(770) 702-1806
Fax
(770) 693-0810
NPI assigned
Jul 27, 2017
Last updated
Aug 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Pamela Weigandt, MDNPI 1144218843
Title
Ceo/Managing Partner
Phone
(770) 702-1806

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

1300 Ridenour Blvd NW Ste 300
Kennesaw, GA 30152-4402

Mailing address

1300 Ridenour Blvd NW Ste 300
Kennesaw, GA 30152-4402
Phone (770) 702-1806

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171116002499 GA Part B Supplier - Clinic/Group Practice 7315203718 Receives reassigned benefits from 205 practitioners
Practice locations: Atlanta, GA; Rome, GA; Sandy Springs, GA; Snellville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 205

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 205

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1609390103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 RIDENOUR BLVD NW STE 300",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524402",
            "telephone_number": "770-702-1806",
            "fax_number": "770-693-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 RIDENOUR BLVD NW STE 300",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524402",
            "telephone_number": "770-702-1806",
            "fax_number": "770-693-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAK ANESTHESIA GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-27",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "WEIGANDT",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "CEO/MANAGING PARTNER",
        "authorized_official_telephone_number": "770-702-1806",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.