Individual provider Active NPI

Marlie Thomas Young, CRNA

  • Certified Registered Nurse Anesthetist
  • Thomasville, GA
National Provider Identifier
1821791252
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN249788 Issued in GA
Practice address
330 N Broad St
Thomasville, GA 31792-8106
Phone
(229) 228-7034
NPI assigned
Mar 24, 2023
Last updated
Oct 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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 RN249788 GA Primary

Addresses

Primary practice location

330 N Broad St
Thomasville, GA 31792-8106

Mailing address

654 US Highway 319 S
Thomasville, GA 31792-1447
Phone (229) 921-6275

Other names 1

  • Marlie Kyndall Thomas Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230525002347 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911363478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Georgia Anesthesia Associates, PCGroup PAC ID 1759349830, 28 clinicians

Practice addresses (Care Compare)

915 Gordon Ave
Thomasville, GA 31792-6614
Phone (229) 551-1883

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Georgia Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2023 Accepting new patients

Locations

330 N Broad St
Ste D2
Thomasville, GA 31792
Phone (912) 228-7034

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

947 S Broad St
Thomasville, GA 31792
Phone (229) 228-3731

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1821791252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 US HIGHWAY 319 S",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317921447",
            "telephone_number": "229-921-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N BROAD ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317928106",
            "telephone_number": "229-228-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARLIE",
        "middle_name": "THOMAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN249788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLIE",
            "last_name": "THOMAS",
            "middle_name": "KYNDALL",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.