Katie R Cacciapalle, CRNA
Individual provider Active NPI Anesthesiologist Assistant · Macon, GA
NPI 1780939561 · NPPES record last updated Oct 17, 2017
Key facts
- NPI
- 1780939561
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiologist Assistant 367H00000X
- Practice address
- 777 Hemlock St
Macon, GA 31201-2102 - Phone
- (478) 633-2147
- Fax
- (478) 742-9670
- NPI assigned
- Jul 18, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sentry Anesthesia Management, LLC
American Anesthesiology Associates of Georgia LLC
Practice addresses (Care Compare)
3708 Northside Dr
Macon, GA 31210-2404
Phone (478) 745-4206
777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-6399
Hospital & facility affiliations
- Atrium Health Navicent the Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171120000524 | GA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 4082862115 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology Associates of Georgia, LLC | Current |
Accepting new patients | |
| Sentry Anesthesia Management, LLC | Current |
Accepting new patients | |
| Kalamazoo Anesthesiology P C | Past | Accepting new patients | |
| North Tampa Anesthesia Consultants | Past | Accepting new patients |
Locations
126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011
2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000
888 Pine St
Macon, GA 31201
Phone (478) 751-0527
1014 Forsyth St
Macon, GA 31201
Phone (478) 633-5800
3708 Northside Dr
Macon, GA 31210
Phone (478) 254-5303
777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | ARNP9301121 | FL | |
| Certified Registered Nurse Anesthetist | 367500000X | 4704296775 | MI | |
| Anesthesiologist Assistant | 367H00000X | GA | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4704296775 | Other | MI | MI LICENSE |
Other names
- Katie M Ruffin
Other providers in Macon, GA
- Hubert R Buxton III
- BWS Major Management Systems
- BWS Major Management Systems
- Bruce Morgan Byrd
- Audrey Cabe
- Raymond Junior Patrick Cadet
- Cal Management Services LLC
- Caldwell & Son Opticians Inc
- Caldwell Counseling Services, LLC
- Courtney Byrd Caldwell
All providers in Macon, GA · Anesthesiologist Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.