Individual provider Active NPI

Jessica Hatfield Randall, CRNA

  • Certified Registered Nurse Anesthetist
  • Kennesaw, GA
National Provider Identifier
1710553474
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN291404 Issued in GA
Practice address
1300 Ridenour Blvd NW Ste 300
Kennesaw, GA 30152-4402
Phone
(770) 702-1806
NPI assigned
Jun 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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 133695 GA
Certified Registered Nurse Anesthetist 367500000X RN291404 GA Primary

Addresses

Primary practice location

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

Mailing address

465 Old Creek Rd
Atlanta, GA 30342-2755
Phone (205) 743-8655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210614000334 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385044379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Anesthesia Professionals, LLCGroup PAC ID 5496134348, 543 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
133695GAMDCertified Registered Nurse Anesthetist
RN291404GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mak Anesthesia Holdings LLC CurrentSince May 1, 2021 Accepting new patients
North Atlanta Anesthesia Professionals, LLC CurrentSince Jul 28, 2025 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1300 Ridenour Blvd NW
Ste 300
Kennesaw, GA 30152
Phone (770) 693-0810

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1710553474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 OLD CREEK RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422755",
            "telephone_number": "205-743-8655"
        },
        {
            "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": "770-702-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JESSICA",
        "middle_name": "HATFIELD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "133695",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN291404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.