Individual provider Active NPI

Denise Jane Frederick, CRNA

  • Certified Registered Nurse Anesthetist
  • Atlanta, GA
National Provider Identifier
1700135670
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN291317 Issued in GA
Practice address
1405 Clifton Rd NE FL 3
Atlanta, GA 30322-1060
Phone
(404) 785-6670
Fax
(404) 785-1362
NPI assigned
Sep 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN291317 GA Primary

Addresses

Primary practice location

1405 Clifton Rd NE FL 3
Atlanta, GA 30322-1060

Mailing address

1405 Clifton Rd NE FL 3
Atlanta, GA 30322-1060
Phone (404) 785-6670

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200326003909 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244480101 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN291317GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Perimeter Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 20, 2020 Accepting new patients
Choa Multispecialty, LLC Current Accepting new patients
Mulkey Anesthesiology Associates LLC CurrentSince Jun 25, 2020 Accepting new patients
Interventional Spine and Pain Management Ambulatory Surgical Center CurrentSince Jun 25, 2020 Accepting new patients
Egleston Pediatric Group Current Accepting new patients
Children'S Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince May 28, 2022 Accepting new patients
Choa Hospital Based, LLC CurrentSince May 28, 2022 Accepting new patients

Locations

1405 Clifton Rd NE
Fl 3
Atlanta, GA 30322
Phone (404) 785-6670

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

3390 Peachtree Rd NE
Ste 1500
Atlanta, GA 30326
Phone 40492049502501

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

3870 Medical Park Dr
Austell, GA 30106
Phone (770) 923-7778

3870 Medical Park Dr
Ste 100
Austell, GA 30106

1388 Wellbrook Cir NE
#A
Conyers, GA 30012
Phone (770) 385-7985

970 Sanders Rd
Ste 100
Cumming, GA 30041

2620 Satellite Blvd
Duluth, GA 30096
Phone (404) 785-8000

505 Jenkins St
Lagrange, GA 30240
Phone (706) 407-0161

2285 Asquith Ave SW
Marietta, GA 30008
Phone (770) 464-5485

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1700135670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE FL 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "404-785-6670",
            "fax_number": "404-785-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE FL 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "404-785-6670",
            "fax_number": "404-785-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "DENISE",
        "middle_name": "JANE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN291317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1405 Clifton Rd NE Fl 3",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303221060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.