Individual provider Active NPI

Anesheia Ceasar Prince, AU.D

  • Audiologist
  • Atlanta, GA
National Provider Identifier
1922369339
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD003899 Issued in GA
Practice address
5555 Peachtree Dunwoody Rd NE
Ste 125
Atlanta, GA 30342-1710
Phone
(404) 255-2918
Fax
(404) 255-5837
NPI assigned
Jun 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD003899 GA Primary

Addresses

Primary practice location

5555 Peachtree Dunwoody Rd NE
Ste 125
Atlanta, GA 30342-1710

Mailing address

5555 Peachtree Dunwoody Rd NE
Ste 125
Atlanta, GA 30342-1710
Phone (404) 255-2918

Other identifiers 1

IdentifierTypeStateIssuer
003124990MedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121017000197 GA Practitioner - Qualified Audiologist 2264682889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Premier Audiology Associates, LLCGroup PAC ID 4789075565, 5 clinicians

Practice addresses (Care Compare)

111 Fieldstone Dr
Suite 106
Milledgeville, GA 31061-7108
Phone (478) 452-0578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Audiology Associates, LLC Audiologist CurrentSince Oct 1, 2021 Accepting new patients
ENT of Georgia, LLC CurrentSince May 31, 2012 Accepting new patients
Hearing Associates, PC Audiologist Past Accepting new patients
Atlanta ENT Sinus & Allergy Associates PC Past Accepting new patients

Locations

1991 N Williamsburg Dr
Ste A100
Decatur, GA 30033

1713 Mount Vernon Rd
Ste 4
Dunwoody, GA 30338
Phone (770) 394-9499

111 Fieldstone Dr
Ste 106
Milledgeville, GA 31061
Phone (478) 452-0578

5673 Peachtree Dunwoody Rd
Ste 150
Sandy Springs, GA 30342
Phone (404) 297-4230

830 Eagles Landing Pkwy
Ste 102
Stockbridge, GA 30281
Phone (678) 534-5922

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1922369339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "STE 125",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421710",
            "telephone_number": "404-255-2918",
            "fax_number": "404-255-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "STE 125",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421710",
            "telephone_number": "404-255-2918",
            "fax_number": "404-255-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "ANESHEIA",
        "middle_name": "CEASAR",
        "name_prefix": "Dr.",
        "credential": "AU.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD003899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003124990",
            "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 Jan 13, 2017; 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.