Individual provider Active NPI

Nancy Y Landry, PA

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1912074956
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
4205 Issued in GA
Practice address
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone
(404) 778-4852
NPI assigned
Nov 28, 2006
Last updated
Oct 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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 4205 GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Atlanta, GA 30322-1059

Mailing address

250 Pharr Rd NE
Unit 510
Atlanta, GA 30305-2464
Phone (404) 944-9642

Other practice location 1

5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 819-6000

Other identifiers 1

IdentifierTypeStateIssuer
450368436AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040602000932 GA Practitioner - Anesthesiology Assistant 2365424587 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Georgia Anesthesia, LLCGroup PAC ID 8426466137, 114 clinicians

Practice addresses (Care Compare)

4700 Waters Ave
(Memorial Health University Medical Center)
Savannah, GA 31404-6220
Phone (912) 350-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004205GAMDPediatric Physical Therapist
4205GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC CurrentSince Nov 1, 2021 Accepting new patients
SE Georgia Anesthesia, LLC CurrentSince Dec 12, 2023 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Sep 16, 2023 Accepting new patients
Anesthesia Consultants of Savannah, PC CurrentSince Apr 1, 2017 Accepting new patients

Locations

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

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1912074956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PHARR RD NE",
            "address_2": "UNIT 510",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052464",
            "telephone_number": "404-944-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-778-4852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5353 Reynolds St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056015",
            "country_code": "US",
            "telephone_number": "912-819-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "NANCY",
        "middle_name": "Y",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "4205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "450368436A",
            "state": "GA"
        }
    ],
    "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 Oct 20, 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.