Individual provider Active NPI

Kameko Edgecombe Burdine, CAA

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1790336006
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
10800 Issued in GA
Practice address
6300 Powers Ferry Rd Ste 600-236
Atlanta, GA 30339-2919
Phone
(305) 810-9880
NPI assigned
Sep 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 10800 GA Primary
Anesthesiology Physician 207L00000X 530 FL
Anesthesiologist Assistant 367H00000X 530 FL

Addresses

Primary practice location

6300 Powers Ferry Rd Ste 600-236
Atlanta, GA 30339-2919

Mailing address

PO Box 945375
Atlanta, GA 30394-5375
Phone (516) 945-3000

Other practice location 1

5353 Reynolds St
Savannah, GA 31405
Phone (912) 819-6000

Other names 1

  • Kameko Roshan Edgecombe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20191112001840 FL Practitioner - Anesthesiology Assistant 9436581584 Reassigns benefits to 1 organization
I20220321001079 GA Practitioner - Anesthesiology Assistant 9436581584 Reassigns benefits to 2 organizations
I20251218003474 SC Practitioner - Anesthesiology Assistant 9436581584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Poston Rd
Suite 105
Charleston, SC 29407-3466

101 E Wood St
Spartanburg, SC 29303-3040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
530FLMDAnesthesiology Physician
10800GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Georgia LLC Anesthesiology CurrentSince Jan 27, 2022 Accepting new patients
American Anesthesiology Associates of Georgia, LLC Anesthesiology CurrentSince Apr 1, 2023 Accepting new patients
Spartanburg Medical Center Anesthesiology CurrentSince Nov 7, 2025 Accepting new patients
Spartanburg Medical Center CurrentSince Nov 7, 2025 Accepting new patients
Brevard Physician Associates, PLLC CurrentSince Jan 11, 2023 Accepting new patients
Brevard Physician Associates, PLLC Anesthesiology CurrentSince Jan 11, 2023 Accepting new patients

Locations

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

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

247 S Main St
Reidsville, GA 30453
Phone (478) 787-6255

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

1600 Medical Way
Snellville, GA 30078
Phone (770) 979-9903

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1790336006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 945375",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303945375",
            "telephone_number": "516-945-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 POWERS FERRY RD STE 600-236",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392919",
            "telephone_number": "305-810-9880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5353 Reynolds St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "31405",
            "country_code": "US",
            "telephone_number": "912-819-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDINE",
        "first_name": "KAMEKO",
        "middle_name": "EDGECOMBE",
        "name_prefix": "Ms.",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "10800",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "530",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "530",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAMEKO",
            "last_name": "EDGECOMBE",
            "middle_name": "ROSHAN",
            "credential": "CAA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.