Individual provider Active NPI

Brian West, CAA

  • Anesthesiologist Assistant
  • Kennesaw, GA
National Provider Identifier
1649646670
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
8126 Issued in GA
Practice address
1300 Ridenour Blvd NW
Kennesaw, GA 30152-4501
Phone
(770) 702-1806
NPI assigned
Aug 13, 2015
Last updated
Dec 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X
Anesthesiologist Assistant 367H00000X 00002262 OH
Anesthesiologist Assistant 367H00000X 8126 GA Primary

Addresses

Primary practice location

1300 Ridenour Blvd NW
Kennesaw, GA 30152-4501

Mailing address

1300 Ridenour Blvd NW
Kennesaw, GA 30152-4501

Other practice location 1

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-3722

Other practice location 2

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8126GAMDInternal Medicine Physician
00002262OHMDAnesthesiologist Assistant
008126GAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mak Anesthesia Holdings LLC CurrentSince Apr 23, 2023 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

4500 Hospital Blvd
Ste 200
Roswell, GA 30076
Phone (770) 676-4600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1649646670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 RIDENOUR BLVD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 RIDENOUR BLVD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524501",
            "telephone_number": "770-702-1806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "216-844-3722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Johnson Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421606",
            "country_code": "US",
            "telephone_number": "404-851-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEST",
        "first_name": "BRIAN",
        "credential": "CAA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-13",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": "00002262",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "8126",
            "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 Dec 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.