Individual provider Active NPI

Samuel T Rawls, MD

  • Anesthesiology Physician
  • Fernandina Beach, FL
National Provider Identifier
1912964586
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME139183 Issued in FL
Practice address
3008A S Fletcher Ave
Fernandina Beach, FL 32034-4597
Phone
(912) 270-1981
Fax
(904) 530-2296
NPI assigned
Apr 27, 2006
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME139183 FL Primary

Addresses

Primary practice location

3008A S Fletcher Ave
Fernandina Beach, FL 32034-4597

Mailing address

3008-A S. Fletcher Ave.
Fernandina Beach, FL 32034-4597
Phone (912) 270-1981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000550 GA Practitioner - Anesthesiology 9931013109 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME139183FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alta Anesthesia Associates of Georgia, PC Anesthesiology CurrentSince Sep 1, 1995 Accepting new patients

Locations

3100 Kemble Ave
Brunswick, GA 31520
Phone (880) 233-2570

777 Gloucester St
Brunswick, GA 31520
Phone (912) 264-9930

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

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1912964586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008-A S. FLETCHER AVE.",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344597",
            "telephone_number": "912-270-1981",
            "fax_number": "904-530-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008A S FLETCHER AVE",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344597",
            "telephone_number": "912-270-1981",
            "fax_number": "904-530-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLS",
        "first_name": "SAMUEL",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME139183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.