Individual provider Active NPI

Mary Ellen Raux, MD

  • Anesthesiology Physician
  • Kennesaw, GA
National Provider Identifier
1679504468
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
025256 Issued in GA
Practice address
1640 Airport Rd NW
Ste 110
Kennesaw, GA 30144-7038
Phone
(678) 202-2074
Fax
(770) 590-1442
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 025256 GA Primary

Addresses

Primary practice location

1640 Airport Rd NW
Ste 110
Kennesaw, GA 30144-7038

Mailing address

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309-5219
Phone (404) 351-1754

Other identifiers 1

IdentifierTypeStateIssuer
00272522MedicaidGA

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fayette Community Anesthesia Anesthesiology Past Accepting new patients
Piedmont Anesthesia Associates, L.L.C Anesthesiology Past Accepting new patients
American Anesthesiology Associates of Georgia, LLC Anesthesiology Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679504468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1984 PEACHTREE RD NW",
            "address_2": "STE 515",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303095219",
            "telephone_number": "404-351-1754",
            "fax_number": "404-351-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 AIRPORT RD NW",
            "address_2": "STE 110",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447038",
            "telephone_number": "678-202-2074",
            "fax_number": "770-590-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUX",
        "first_name": "MARY ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "025256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00272522",
            "state": "GA"
        }
    ],
    "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 Jul 8, 2007; 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.