Individual provider Active NPI

John James Zitzelberger II, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Moore, GA
National Provider Identifier
1851392146
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN124557 Issued in GA
Practice address
6600 Van Aalst Blvd BLDG 9250
Fort Moore, GA 31905-2102
Phone
(706) 888-2733
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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 1-117462 AL
Certified Registered Nurse Anesthetist 367500000X RN124557 GA Primary

Addresses

Primary practice location

6600 Van Aalst Blvd BLDG 9250
Fort Moore, GA 31905-2102

Mailing address

6534 Beaver TRL
Midland, GA 31820-4317
Phone (762) 408-3107

Other identifiers 1

IdentifierTypeStateIssuer
000941432BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080131000404 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779665591 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentry Anesthesia Management, LLCGroup PAC ID 9436372323, 170 clinicians

Practice addresses (Care Compare)

1514 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 882-1411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1-117462ALMDCertified Registered Nurse Anesthetist
RN124557GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Amsol Anesthetists of Georgia LLC-Hughston Surgical Center Nurse Anesthetist, Certified Registered CurrentSince Oct 6, 2009 Accepting new patients
Southern Crescent Anesthesiology, PC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2008 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince May 2, 2014 Accepting new patients
Amsol Anesthetists of Georgia, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 6, 2009 Accepting new patients

Locations

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

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

2548 Weems Rd
Columbus, GA 31909
Phone (404) 265-4000

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

7351 Old Moon Rd
Columbus, GA 31909
Phone (706) 221-2721

1514 Vernon Rd
Lagrange, GA 30240
Phone (706) 812-2369

3150 Highway 34 E
#195
Newnan, GA 30265

3150 Highway 34 E
Ste 195
Newnan, GA 30265

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1851392146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6534 BEAVER TRL",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318204317",
            "telephone_number": "762-408-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD BLDG 9250",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "706-888-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZITZELBERGER",
        "first_name": "JOHN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-117462",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN124557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000941432B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Moore, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.