Individual provider Active NPI

Kaitlyn A Tinney, AA-C

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1902157126
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
006586 Issued in GA
Practice address
5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342-1764
Phone
(678) 843-7324
Fax
(404) 843-2627
NPI assigned
Sep 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 006586 GA Primary

Addresses

Primary practice location

5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342-1764

Mailing address

5671 Peachtree Dunwoody Rd NE
Suite 530
Atlanta, GA 30342-5000
Phone (404) 257-1415

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130214000076 GA Practitioner - Anesthesiology Assistant 8729232079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Specialists in Anesthesia, P.C.Group PAC ID 9830170059, 112 clinicians

Practice addresses (Care Compare)

5671 Peachtree Dunwoody Rd
Suite 800
Atlanta, GA 30342-5021
Phone (404) 257-1415

Hospital & facility affiliations

  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
006586GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Specialists in Anesthesia, P.C. Anesthesiologist Assistant CurrentSince Oct 1, 2012 Accepting new patients

Locations

5665 Ptree Dunwoody Rd NE
Sandy Springs, GA 30342
Phone (678) 843-7001

5671 Ptree Dunwoody Rd NE
Ste 530
Sandy Springs, GA 30342
Phone (404) 257-1415

5671 Ptree Dunwoody Rd NE
Ste 800
Sandy Springs, GA 30342
Phone (404) 257-1415

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 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": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1902157126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 530",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425000",
            "telephone_number": "404-257-1415",
            "fax_number": "404-851-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 PEACHTREE DUNWOODY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421764",
            "telephone_number": "678-843-7324",
            "fax_number": "404-843-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINNEY",
        "first_name": "KAITLYN",
        "middle_name": "A",
        "credential": "AA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "006586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.