Individual provider Active NPI

Jordan Lane Truby

  • Certified Registered Nurse Anesthetist
  • Newnan, GA
National Provider Identifier
1861170458
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
145632 Issued in GA
Practice address
600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone
(770) 744-4809
NPI assigned
Jul 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 924764 TX
Certified Registered Nurse Anesthetist 367500000X 145632 GA Primary

Addresses

Primary practice location

600 Celebrate Life Pkwy
Newnan, GA 30265-8001

Mailing address

600 Celebrate Life Parkway
Newnan, GA 30265
Phone (770) 744-4809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MD, DE, PA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20231013000112 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638524564 Reassigns benefits to 5 organizations
I20250505000984 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638524564 Reassigns benefits to 1 organization
I20250506001401 DE Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638524564 Reassigns benefits to 1 organization
I20260303001161 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638524564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Company LLCGroup PAC ID 4587559026, 373 clinicians
TMC-West Georgia Anesthesia Associates Inc.Group PAC ID 2365456308, 67 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 546-6400

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 782-3282

1995 Technology Pkwy
Mechanicsburg, PA 17050-8522
Phone (717) 782-3282

705 Dixie St
Carrollton, GA 30117-3818
Phone (800) 232-5703

801 Middleford Rd
Seaford, DE 19973-3636
Phone (302) 629-6611

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
924764TXMDRegistered Nurse
145632GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Concordia Anesthesiology, Inc CurrentSince Sep 15, 2023 Accepting new patients
Anesthesia Company, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2025 Accepting new patients
Ams Southeast LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 3, 2024 Accepting new patients
Upmc Pinnacle Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 5, 2026 Accepting new patients
TMC-West Georgia Anesthesia Associates Inc. Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
SG Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 17, 2025 Accepting new patients

Locations

801 Middleford Rd
Seaford, DE 19973
Phone (302) 628-9178

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

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

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

11650 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 543-8132

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

70 Sherry Ln
Ste 101
Prnc Frederck, MD 20678
Phone (410) 889-2040

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

Organizations & group practices 8

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.

Hospital & facility affiliations 9

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": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1861170458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PARKWAY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "30265",
            "telephone_number": "770-744-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658001",
            "telephone_number": "770-744-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUBY",
        "first_name": "JORDAN",
        "middle_name": "LANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "924764",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "145632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.