Jerry Tee Todd, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

76501 Issued in GA

Practice address

1300 Ridenour Blvd NW Ste 300
Kennesaw, GA 30152-4402

Phone

(770) 634-4215

NPI assigned

Mar 31, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Medical College of Georgia School of Medicine, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Mak Anesthesia Holdings LLC

  • Anesthesiology Physician
  • Kennesaw, GA
  • NPI 1912452939
  Medicare reassignment Care Compare group NPD
• Ambulatory Anesthesia Partners LLC

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1851799373
  Medicare reassignment NPD
• Capitol Anesthesiology, PC

  • Anesthesiology Physician
  • Morrow, GA
  • NPI 1245287192
  Medicare reassignment NPD
• Mak Anesthesia Georgia, LLC

  • Anesthesiology Physician
  • Kennesaw, GA
  • NPI 1609390103
  Medicare reassignment NPD
• Northlake Anesthesia Professionals, LLC

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1982637419
  Medicare reassignment NPD
• Radius Anesthesia of Georgia LLC

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1861996225
  Medicare reassignment NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  GA

  Medicare reassignment NPD
• Amsol Anesthetists of Georgia, LLC

  • Certified Registered Nurse Anesthetist
  • Columbus, GA
  • NPI 1649224775
  Medicare reassignment

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

{
    "created_epoch": "1333152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584835200000",
    "number": "1699041863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3999 MATTY DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300661113",
            "telephone_number": "770-634-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 RIDENOUR BLVD NW STE 300",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524402",
            "telephone_number": "770-634-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "JERRY",
        "middle_name": "TEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-31",
        "last_updated": "2020-03-22",
        "certification_date": "2020-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "MD.35302",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "76501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharika Tillman, FNP -BC
• Tiara Timothy
• Justin Michael Tinsley, DC
• Octavio Andres Tobar
• Todd Supnick DC PC
• Laura Todd, LPN
• Tyanne Jahnae Topps
• Craig Torell, M.A., M.DIV., LPC
• Elisa Torell
• Jamie Michelle Tortorice, ATC

• Anesthesiology Physician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Anesthesiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.