Mark Anthony Lumsden, CAA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

Practice address

1700 Medical Way
Snellville, GA 30078-2195

Phone

(707) 979-0200

Fax

(678) 352-4322

NPI assigned

Sep 6, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Premier Anesthesia of Georgia LLCGroup PAC ID 6608123724, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

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.

• Premier Anesthesia of Georgia LLC

  • Anesthesiology Physician
  • Snellville, GA
  • NPI 1811403207

  Anesthesiologist Assistant

  Medicare reassignment Care Compare group NPD

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

• Eastside Medical Center, LLC

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1760103154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3457 DRAYTON MANOR RUN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300469417",
            "telephone_number": "201-406-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MEDICAL WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782195",
            "telephone_number": "707-979-0200",
            "fax_number": "678-352-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMSDEN",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "credential": "CAA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@jacksonrevenue.com",
            "affiliation": "Y",
            "affiliationName": "Premier Anesthesia of Georgia LLC",
            "address_1": "1700 Medical Way",
            "city": "Snellville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300782195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nickia Shawnell Lowery, MHS. LPC, NCC
• Sierra T Lowery, PA-C
• LP Healthcare LLC
• Salome L Lulusa
• Lumenmed LLC
• Marshall Eli Lutske, MD
• Duy Duc Luu, PHARMD
• Luxe Testfusion LLC
• Luxottica of America Inc
• Luxottica of America Inc.

• Anesthesiologist Assistant in Snellville, GA
• Providers in Snellville, GA by specialty
• Anesthesiologist Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.