Individual provider Active NPI

Mary C Quinn, CRNA

  • Certified Registered Nurse Anesthetist
  • Macon, GA
National Provider Identifier
1780739987
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN105805 Issued in GA
Practice address
777 Hemlock St
Macon, GA 31201-2102
Phone
(866) 507-5244
Fax
(855) 851-4405
NPI assigned
Jan 25, 2007
Last updated
Nov 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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 RN105805 GA Primary

Addresses

Primary practice location

777 Hemlock St
Macon, GA 31201-2102

Mailing address

PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110309000289 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931381100 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 29, 2021 Accepting new patients
South Metro Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2021 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Nov 1, 2014 Accepting new patients
Macon Gastroenterology Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients

Locations

2675 N Decatur Rd
Ste 506
Decatur, GA 30033
Phone (404) 299-1679

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

4865 Bill Gardner Pkwy
Locust Grove, GA 30248
Phone (770) 692-0100

610 3rd St
Ste 102
Macon, GA 31201
Phone (478) 202-8691

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

888 Pine St
Macon, GA 31201
Phone (478) 751-0527

6555 Professional Pl
Ste B
Riverdale, GA 30274
Phone (770) 692-0100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDFJAD

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1780739987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "855-851-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "866-507-5244",
            "fax_number": "855-851-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "MARY",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN105805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.