NPIMap

Organization Active NPI

At Your Service Anesthesia and Therapeutics, LLC

  • Anesthesiology Physician
  • Stone Mountain, GA
National Provider Identifier
1689327322
Registry record updated Jan 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
AT YOUR SERVICE ANESTHESIA AND THERAPEUTICS, LLC
Practice address
1785 E Park Place Blvd Ste 212
Stone Mountain, GA 30087-3458
Phone
(470) 395-6076
Fax
(470) 745-0716
NPI assigned
Feb 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2023

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

Authorized official

Name
Dr. Selwynn Bryan Howard, MDNPI 1255302675
Title
Ceo /President
Phone
(470) 395-6076

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1785 E Park Place Blvd Ste 212
Stone Mountain, GA 30087-3458

Mailing address

PO Box 870822
Stone Mountain, GA 30087-0021
Phone (470) 395-6076

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230227000194 GA Part B Supplier - Clinic/Group Practice 0840663654 Receives reassigned benefits from 6 practitioners
Practice locations: Stone Mountain, GA

National Provider Directory

National Provider Directory

Locations

1805 Honey Creek Cmns SE
Ste B
Conyers, GA 30013
Phone (770) 920-7000

1785 E Park Place Blvd
Ste 212
Stone Mtn, GA 30087
Phone (470) 395-6076

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673654400000",
    "number": "1689327322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 870822",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300870021",
            "telephone_number": "470-395-6076",
            "fax_number": "470-745-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 E PARK PLACE BLVD STE 212",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873458",
            "telephone_number": "470-395-6076",
            "fax_number": "470-745-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT YOUR SERVICE ANESTHESIA AND THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-02",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-14",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "SELWYNN",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "CEO /PRESIDENT",
        "authorized_official_telephone_number": "470-395-6076",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.