Individual provider Active NPI

Holly D. Payne, CRNA

  • Certified Registered Nurse Anesthetist
  • Calhoun, GA
National Provider Identifier
1700105103
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN144655 Issued in GA
Practice address
1035 Red Bud Rd NE
Calhoun, GA 30701-6010
Phone
(706) 879-4776
Fax
(706) 879-5841
NPI assigned
May 25, 2010
Last updated
Dec 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 8059565-4406 UT
Certified Registered Nurse Anesthetist 367500000X RN144655 GA Primary

Addresses

Primary practice location

1035 Red Bud Rd NE
Calhoun, GA 30701-6010

Mailing address

PO Box 12938
C/O Clinic Management
Calhoun, GA 30703

Other identifiers 1

IdentifierTypeStateIssuer
584441624HMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100719000607 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305978867 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RG Anesthesia LLCGroup PAC ID 1052543287, 5 clinicians

Practice addresses (Care Compare)

11 John Maddox Dr NW
Rome, GA 30165-1413
Phone (706) 295-3992

Merit-based Incentive Payment System (MIPS)

Final score
83.79 of 100Reported as group
Quality
68.23
Promoting interoperability
100
Improvement activities
40
Cost
74.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN144655GAMDCertified Registered Nurse Anesthetist
8059565-4406UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
RG Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince May 8, 2023 Accepting new patients
Northern Georgia Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince May 15, 2025 Accepting new patients
Calhoun Anesthesia P C CurrentSince Jul 1, 2014 Accepting new patients
Adventist Health System Georgia Inc CurrentSince Feb 1, 2016 Accepting new patients

Locations

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

134 Mountainside Village Pkwy
Bldg 500
Jasper, GA 30143
Phone (706) 253-7340

11 John Maddox Dr NW
Rome, GA 30165
Phone (406) 295-3992

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1700105103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12938",
            "address_2": "C/O CLINIC MANAGEMENT",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "30703",
            "fax_number": "478-745-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 RED BUD RD NE",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307016010",
            "telephone_number": "706-879-4776",
            "fax_number": "706-879-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "HOLLY",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-25",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "8059565-4406",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN144655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "584441624H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.