Jacob Theodore Tuttle, CRNA

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN292693 Issued in GA

Practice address

1520 Clifton Rd NE Ofc 117
Atlanta, GA 30322-4201

Phone

(404) 727-6946

NPI assigned

Feb 10, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Choa Hospital Based, LLCGroup PAC ID 4688812498, 97 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488
  Medicare reassignment Care Compare group NPD
• Choa Multispecialty, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1437493467
  NPD

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1689489502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1967 COBBLESTONE CIR NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303194906",
            "telephone_number": "404-862-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 CLIFTON RD NE OFC 117",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224201",
            "telephone_number": "404-727-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "JACOB",
        "middle_name": "THEODORE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN292693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Star Tutmaher, DO
• Chrystyl D Tutt, PSY.D.
• Amelia E. Tuttle, MS, LMFT
• Gordon Edward Tuttle, PH.D.
• Hope Tuttle
• Jessica Tuttle, M.D.
• Richard Tutu, PA
• Valarie Tutuh
• Tatiana Tvrdik, PHD
• TW Consulting Co

• Registered Nurse in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.