NPIMap

Organization Active NPI

Southern Sleepers Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Douglas, GA
National Provider Identifier
1720520646
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
SOUTHERN SLEEPERS ANESTHESIA LLC
Practice address
300 Shirley Ave
Douglas, GA 31533-2332
Phone
(229) 469-7653
Fax
(226) 469-7655
NPI assigned
Nov 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Authorized official

Name
Keri PaulkNPI 1144525940
Title
Crna
Phone
(229) 646-1348

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

300 Shirley Ave
Douglas, GA 31533-2332

Mailing address

PO Box 661495
Birmingham, AL 35266-1495
Phone (205) 979-5882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170206000613 GA Part B Supplier - Clinic/Group Practice 3870876469 Receives reassigned benefits from 5 practitioners
Practice locations: Douglas, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1720520646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661495",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352661495",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SHIRLEY AVE",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332332",
            "telephone_number": "229-469-7653",
            "fax_number": "226-469-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SLEEPERS ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-09",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "PAULK",
        "authorized_official_first_name": "KERI",
        "authorized_official_title_or_position": "CRNA",
        "authorized_official_telephone_number": "229-646-1348"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.