Individual provider Active NPI

Amanda Johnstun

  • Certified Registered Nurse Anesthetist
  • Grovetown, GA
National Provider Identifier
1891150595
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN-CRNA209314 Issued in GA
Practice address
645 Shipley Ave
Grovetown, GA 30813-4249
Phone
(706) 836-8161
NPI assigned
Dec 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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 APRN-CRNA209314 GA Primary

Addresses

Primary practice location

645 Shipley Ave
Grovetown, GA 30813-4249

Mailing address

645 Shipley Ave
Grovetown, GA 30813-4249

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160218000650 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294030946 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians
Anesthesia Consultants of Augusta LLCGroup PAC ID 6204905763, 79 clinicians
Southern Anesthesia of Augusta LLCGroup PAC ID 5294030466, 8 clinicians

Practice addresses (Care Compare)

1350 Walton Way
Augusta, GA 30901-2612
Phone (478) 746-7577

3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 855-9860

905 Stevens Creek Rd
Augusta, GA 30907-3201
Phone 7067379250109

Hospital & facility affiliations

  • Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-CRNA209314GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Anesthesia of Augusta LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2022 Accepting new patients
Piedmont Anesthesia LLC CurrentSince Oct 9, 2022 Accepting new patients
Anesthesia Consultants of Augusta, LLC CurrentSince Feb 10, 2016 Accepting new patients
Anesthesia and Pain Medicine Past Accepting new patients
Southern Anesthesia of Augusta LLC Nurse Anesthetist, Certified Registered PastSince Oct 22, 2023 Accepting new patients

Locations

905 Stevens Creek Rd
Augusta, GA 30907
Phone (706) 722-3458

811 13th St
Ste 17
Augusta, GA 30901
Phone (706) 650-1056

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

1321 Interstate Pkwy
Augusta, GA 30909
Phone (706) 738-7246

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

462 Furys Ferry Rd
Martinez, GA 30907
Phone (706) 868-0319

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

351 S Liberty St
Waynesboro, GA 30830
Phone (706) 554-4435

110 Pepper Hill Way
Aiken, SC 29801
Phone (803) 642-6060

Organizations & group practices 5

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 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": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1891150595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 SHIPLEY AVE",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308134249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 SHIPLEY AVE",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308134249",
            "telephone_number": "706-836-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTUN",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "APRN-CRNA209314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grovetown, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; 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.