NPIMap

Organization Active NPI

Rockdale Anesthesia Services, P.C.

  • Anesthesiology Physician
  • Conyers, GA
National Provider Identifier
1619028396
Registry record updated Feb 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
J711633 Issued in GA
Legal business name
ROCKDALE ANESTHESIA SERVICES, P.C.
Practice address
1359 Milstead Rd NE
Suite 103
Conyers, GA 30012-3865
Phone
(770) 388-7745
Fax
(770) 922-0526
NPI assigned
Jan 16, 2007
Last updated
Feb 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2010

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

Authorized official

Name
Dr. Selwynn B. Howard, MDNPI 1255302675
Title
President
Phone
(770) 388-7745

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X J711633 GA Primary

Addresses

Primary practice location

1359 Milstead Rd NE
Suite 103
Conyers, GA 30012-3865

Mailing address

PO Box 1078
Conyers, GA 30012-1078
Phone (770) 388-7745

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000436 GA Part B Supplier - Clinic/Group Practice 4284536855 Receives reassigned benefits from 57 practitioners
Practice locations: Conyers, GA

National Provider Directory

National Provider Directory

Locations

1388B Wellbrook Cir NE
Conyers, GA 30012
Phone (770) 388-7745

343 Salem Gate Dr SE
Ste 201
Conyers, GA 30013
Phone (770) 388-7745

Practitioners & affiliated clinicians

Practitioners 84

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 84

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1619028396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1078",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300121078",
            "telephone_number": "770-388-7745",
            "fax_number": "770-922-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 MILSTEAD RD NE",
            "address_2": "SUITE 103",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123865",
            "telephone_number": "770-388-7745",
            "fax_number": "770-922-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKDALE ANESTHESIA SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "SELWYNN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-388-7745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "J711633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; 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.