Individual provider Active NPI

Georgette Backus Bragg, CRNA

  • Certified Registered Nurse Anesthetist
  • Savannah, GA
National Provider Identifier
1679792931
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN055680 Issued in GA
Practice address
101 Egret PT
Savannah, GA 31405-8111
Phone
(912) 232-4110
NPI assigned
Apr 25, 2007
Last updated
Sep 14, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 34544 GA
Certified Registered Nurse Anesthetist 367500000X RN055680 GA Primary

Addresses

Primary practice location

101 Egret PT
Savannah, GA 31405-8111

Mailing address

101 Egret PT
Savannah, GA 31405-8111
Phone (912) 232-4110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080630000055 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628140183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Medical University of South Carolina College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alta Anesthesia Associates of Georgia, PCGroup PAC ID 8729992987, 42 clinicians

Practice addresses (Care Compare)

3100 Kemble Ave
Brunswick, GA 31520-4211
Phone (880) 233-2570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
34544GAMDAmbulatory Surgical Clinic/Center
RN055680GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Alta Anesthesia Associates of Georgia, PC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2016 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Mar 16, 2016 Accepting new patients

Locations

3100 Kemble Ave
Brunswick, GA 31520
Phone (880) 233-2570

777 Gloucester St
Brunswick, GA 31520
Phone (912) 264-9930

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

2000 Dan Proctor Dr
Saint Marys, GA 31558
Phone (912) 576-6160

519 Stephenson Ave
Savannah, GA 31405

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1679792931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 EGRET PT",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314058111",
            "telephone_number": "912-232-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EGRET PT",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314058111",
            "telephone_number": "912-232-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGG",
        "first_name": "GEORGETTE",
        "middle_name": "BACKUS",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "34544",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN055680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.