NPIMap

Organization Active NPI

Concordia Anesthesiology, Inc

  • Anesthesiology Physician
  • Atlanta, GA
National Provider Identifier
1619296464
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
CONCORDIA ANESTHESIOLOGY, INC
Practice address
183 Mystic Place NE
Atlanta, GA 30342
Phone
(404) 478-8785
NPI assigned
May 19, 2010
Last updated
Sep 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Stephan Gosch
Title
Manager
Phone
(404) 543-0304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

183 Mystic Place NE
Atlanta, GA 30342

Mailing address

3379 Peachtree Rd NE Ste 230
Atlanta, GA 30326-1020
Phone (404) 478-8785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100819000220 GA Part B Supplier - Clinic/Group Practice 8325172885 Receives reassigned benefits from 203 practitioners
Practice locations: Alpharetta, GA; Atlanta, GA; Elberton, GA; Gainesville, GA; Roswell, GA; Tucker, GA
O20150127000437 SC Part B Supplier - Clinic/Group Practice 8325172885 Receives reassigned benefits from 73 practitioners
Practice locations: Greenville, SC; Spartanburg, SC; Columbia, SC

National Provider Directory

National Provider Directory

Locations

3379 Peachtree Rd NE
Ste 230
Atlanta, GA 30326
Phone (404) 478-8785

1485 Jesse Jewell Pkwy NE
Ste 180
Gainesville, GA 30501
Phone (706) 521-8413

550 Professional Dr
Lawrenceville, GA 30046
Phone (404) 953-0495

11650 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 543-8132

183 Mystic Pl
Sandy Springs, GA 30342
Phone (404) 478-8785

919 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 289-7700

1920 Pickens St
Columbia, SC 29201
Phone (803) 254-7732

391 Serpentine Dr
Ste 200
Spartanburg, SC 29303
Phone (864) 583-6381

Practitioners & affiliated clinicians

Practitioners 301

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 301

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1619296464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3379 PEACHTREE RD NE STE 230",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261020",
            "telephone_number": "404-478-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 MYSTIC PLACE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-478-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORDIA ANESTHESIOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-19",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "GOSCH",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-543-0304"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "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 Sep 29, 2023; 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.