Individual provider Active NPI

Latoya Leigh Wise, CRNA

  • Certified Registered Nurse Anesthetist
  • Fayetteville, GA
National Provider Identifier
1831456284
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP134506 Issued in TX
Practice address
1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone
(770) 719-7000
NPI assigned
Apr 23, 2012
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 161834 GA
Certified Registered Nurse Anesthetist 367500000X AP134506 TX Primary

Addresses

Primary practice location

1255 Highway 54 W
Fayetteville, GA 30214-4526

Mailing address

P.O. Box 650865
Dallas, TX 75265-0865
Phone (972) 233-1999

Other practice location 1

180 Victoria Dr
Fayetteville, GA 30214-1163
Phone (404) 379-7052

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120613000166 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577727031 Reassigns benefits to 23 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians
Gi Anesthesia of Georgia LLCGroup PAC ID 0446516769, 117 clinicians
Redmond Anesthesia and Pain Treatment, PCGroup PAC ID 4880841741, 77 clinicians

Practice addresses (Care Compare)

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

340 N Milledge Ave
Suite a
Athens, GA 30601-3806
Phone (706) 548-0008

501 Redmond Rd NW
Rome, GA 30165-1415
Phone (706) 291-0291

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
161834GAMDCertified Registered Nurse Anesthetist
AP134506TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
SG Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 18, 2014 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince May 9, 2016 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Jan 1, 2025 Accepting new patients
Sleep Ezzy CurrentSince Jan 8, 2019 Accepting new patients
Progressive Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2015 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Jan 5, 2021 Accepting new patients
RG Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 18, 2014 Accepting new patients
Greater Atlanta Anesthesia, LLC CurrentSince Feb 1, 2015 Accepting new patients
Gi Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 9, 2021 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince May 9, 2016 Accepting new patients
Xenon Anesthesia of Georgia LLC CurrentSince Mar 10, 2019 Accepting new patients
Piedmont Anesthesia Associates, L.L.C CurrentSince Feb 3, 2025 Accepting new patients
Emory Specialty Associates, LLC CurrentSince Apr 1, 2022 Accepting new patients
Gwinnett Physician Group, LLC CurrentSince Jan 5, 2021 Accepting new patients
WGG Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2015 Accepting new patients
Concordia Anesthesiology, Inc CurrentSince Jul 9, 2013 Accepting new patients
Piedmont Anesthesia LLC CurrentSince Nov 28, 2023 Accepting new patients
Coastal Ambulatory Anesthesia LLC CurrentSince Nov 19, 2021 Accepting new patients
Au Medical Associates Anesthesia Billing Services, LLC CurrentSince Mar 17, 2020 Accepting new patients
Gastrointestinal Specialist of Georgia CurrentSince Mar 31, 2023 Accepting new patients
Premier Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 30, 2018 Accepting new patients
Redmond Anesthesia and Pain Treatment, PC Nurse Anesthetist, Certified Registered CurrentSince Sep 20, 2025 Accepting new patients
Au Anesthesiology LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 7, 2014 Accepting new patients
Northside Primary Care Professional Services,LLC CurrentSince Jan 5, 2021 Accepting new patients
Southcare Anesthesia Services, LLC CurrentSince Jan 15, 2019 Accepting new patients
Grady Health System Past Accepting new patients
Premier Anesthesia of Mississippi LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Georgia Pain and Spine Solutions, PC Past Accepting new patients

Locations (25 of 41)

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

340 N Milledge Ave
Ste A
Athens, GA 30601
Phone (706) 548-0008

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

95 Collier Rd NW
Ste 4075
Atlanta, GA 30309
Phone (404) 355-2200

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

3825 Medical Park Dr
Ste 300
Austell, GA 30106
Phone (770) 941-4810

160 Clinic Ave
Carrollton, GA 30117
Phone (770) 214-2800

6262 Veterans Pkwy
Columbus, GA 31909
Phone (706) 494-3071

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

3400 McClure Bridge Rd
Ste A102
Duluth, GA 30096
Phone (917) 621-6854

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

1265 Highway 54 W
Ste 401
Fayetteville, GA 30214
Phone (678) 617-6505

1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499

625 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 532-0292

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

6335 Hospital Pkwy
Ste 208
Johns Creek, GA 30097
Phone (404) 645-7150

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

301 Philip Blvd
Ste B
Lawrenceville, GA 30046
Phone (770) 682-7220

455 Philip Blvd
Ste 138
Lawrenceville, GA 30046

763 Old Norcross Rd
Lawrenceville, GA 30046
Phone (678) 985-1994

892 Legacy Park Dr
Lawrenceville, GA 30043

367 Athens Hwy
Ste 100A
Loganville, GA 30052
Phone (678) 466-6760

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18187/brand/1/csg/1/fhir/r4
  • FHIR API: https://surescripts.gmh.edu/OAuth2PRD/GHSMYC/api/FHIR/R4/

Organizations & group practices 28

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.

View all 28

Hospital & facility affiliations 1

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1831456284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 650865",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650865",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144526",
            "telephone_number": "770-719-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Victoria Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302141163",
            "country_code": "US",
            "telephone_number": "404-379-7052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "LATOYA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "161834",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP134506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.