NPIMap

Organization Active NPI

Vertex Anesthesia Associates LLC

  • Certified Registered Nurse Anesthetist
  • Macon, GA
National Provider Identifier
1649008970
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
VERTEX ANESTHESIA ASSOCIATES LLC
Practice address
577 Mulberry St Ste 110
Macon, GA 31201-8220
Phone
(888) 728-0882
NPI assigned
Jul 26, 2024
Last updated
Jul 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Authorized official

Name
Nicole Nobles PaulkNPI 1154220788
Title
Coo
Phone
(888) 728-0882

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

577 Mulberry St Ste 110
Macon, GA 31201-8220

Mailing address

577 Mulberry St Ste 110
Macon, GA 31201-8220
Phone (888) 728-0882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250131000647 GA Part B Supplier - Clinic/Group Practice 8022547306 Receives reassigned benefits from 29 practitioners
Practice locations: Suwanee, GA; Waycross, GA; Covington, GA; Carrollton, GA; Calhoun, GA; Athens, GA; Albany, GA

National Provider Directory

National Provider Directory

Locations

2709 Meredyth Dr
Ste 120
Albany, GA 31707
Phone (229) 432-7012

4060 Johns Creek Pkwy
Suwanee, GA 30024
Phone (404) 805-6167

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1649008970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 MULBERRY ST STE 110",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018220",
            "telephone_number": "888-728-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 MULBERRY ST STE 110",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018220",
            "telephone_number": "888-728-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERTEX ANESTHESIA ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "PAULK",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "NOBLES",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "888-728-0882"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.