Individual provider Active NPI

Conelia Stacie Avery, CRNA

  • Certified Registered Nurse Anesthetist
  • Newnan, GA
National Provider Identifier
1942336581
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN144288 CRNA Issued in GA
Practice address
2326 Highway 34 E Ste 100
Newnan, GA 30265-1328
Phone
(770) 683-9840
NPI assigned
Feb 26, 2007
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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 RN144288 CRNA GA Primary

Addresses

Primary practice location

2326 Highway 34 E Ste 100
Newnan, GA 30265-1328

Mailing address

1115 Montclair Dr
Peachtree City, GA 30269-1879
Phone (678) 371-6105

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080110000041 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537249024 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Everest Anesthesia LLCGroup PAC ID 2961868559, 18 clinicians
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Practice addresses (Care Compare)

1265 Hwy 54 W
Suite 401
Fayetteville, GA 30214-4537
Phone (843) 651-2624

34 Upper Riverdale Rd SE
Suite 201
Riverdale, GA 30274-2635
Phone (678) 904-9710

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN144288 CRNAGAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 26, 2023 Accepting new patients
Progressive Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 23, 2012 Accepting new patients
Gi Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 14, 2022 Accepting new patients
Everest Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 19, 2023 Accepting new patients
Concordia Anesthesiology, Inc CurrentSince Jul 1, 2010 Accepting new patients
Coastal Ambulatory Anesthesia LLC CurrentSince Feb 1, 2022 Accepting new patients
Newnan Anesthesia Associates, LLC Past Accepting new patients
Fayette Community Anesthesia Past Accepting new patients
Northside Cherokee Anesthesia Consultants, PC Past Accepting new patients
Southern Crescent Anesthesiology, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Piedmont Anesthesia Associates, L.L.C Past Accepting new patients
Henry C. Ballance & Associates, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Southern Crescent Nurse Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Digestive Healthcare of Ga, P.C. Past Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

340 N Milledge Ave
Ste A
Athens, GA 30601
Phone (706) 548-0008

550 Peachtree St NE
Ste 1660
Atlanta, GA 30308
Phone (404) 253-6820

2675 N Decatur Rd
Ste 506
Decatur, GA 30033
Phone (404) 299-1679

8855 Hospital Dr
Ste 102
Douglasville, GA 30134
Phone (678) 784-5020

1265 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-7000

1265 Highway 54 W
Ste 401
Fayetteville, GA 30214
Phone (678) 617-6505

1265 Highway 54 W
Ste 402
Fayetteville, GA 30214
Phone (678) 817-6550

1945 Beverly Rd
Gainesville, GA 30501
Phone (770) 287-1500

1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499

226 E College St
#A
Griffin, GA 30224
Phone (678) 987-1490

301 Philip Blvd
Ste B
Lawrenceville, GA 30046
Phone (770) 682-7220

488 Kennesaw Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 427-3075

1200 Lower Fayetteville Rd
#A
Newnan, GA 30265
Phone (404) 881-1094

60 Hospital Rd
Newnan, GA 30263
Phone (770) 253-1912

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

34 Upper Riverdale Rd SE
Ste 201
Riverdale, GA 30274
Phone (678) 904-0094

11650 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 543-8132

5671 Ptree Dunwoody Rd NE
Ste 680
Sandy Springs, GA 30342
Phone (404) 705-6985

1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200

150 N Park Trl
#A
Stockbridge, GA 30281
Phone (770) 507-0909

4275 Johns Creek Pkwy
Ste A
Suwanee, GA 30024
Phone (678) 475-1606

900 Towne Lake Pkwy
Ste 310
Woodstock, GA 30189
Phone (770) 926-0071

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1942336581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 MONTCLAIR DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691879",
            "telephone_number": "678-371-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2326 HIGHWAY 34 E STE 100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651328",
            "telephone_number": "770-683-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "CONELIA",
        "middle_name": "STACIE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN144288 CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.