Mac Bradley Davis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN168512 Issued in GA

Practice address

209 North Cuthbert Street
Colquitt, GA 39837

Phone

(229) 220-4498

NPI assigned

Aug 4, 2010

Last updated

Aug 4, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, FL2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sweet Dreams Anesthesiology Nurses of Georgia LLCGroup PAC ID 0941456446, 6 clinicians

Overwatch AnesthesiaGroup PAC ID 3678949146, 69 clinicians

Integrated Anesthesia Solutions LLCGroup PAC ID 2466972377, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations (25 of 69)

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18188/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-myrecord.cerner.com/r4/66097e3b-7cef-4b96-acca-38bfaae85903/
• FHIR API: https://fhir4.healow.com/fhir/r4/BIJACD

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.

• Integrated Anesthesia Solutions, LLC

  • Certified Registered Nurse Anesthetist
  • Macon, GA
  • NPI 1205656618

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Overwatch Anesthesia

  • Certified Registered Nurse Anesthetist
  • Macon, GA
  • NPI 1528616810

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Sweet Dreams Anesthesiology Nurses of Georgia LLC

  • Certified Registered Nurse Anesthetist
  • Macon, GA
  • NPI 1669737409

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• General Anesthesia Services, LLC

  • Certified Registered Nurse Anesthetist
  • Hazlehurst, GA
  • NPI 1134509680

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Grady General Hospital

  • General Acute Care Hospital
  • Cairo, GA
  • NPI 1013961507
  Medicare reassignment NPD
• Grand Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Macon, GA
  • NPI 1689230724

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ironcrest Anesthesia LLC

  • Anesthesiology Physician
  • Milledgeville, GA
  • NPI 1114815271

  FL

  Medicare reassignment NPD
• Okefenokee Anesthesia Company LLC

  • Certified Registered Nurse Anesthetist
  • Waycross, GA
  • NPI 1538403324

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• Radiance Anesthesia

  • Certified Registered Nurse Anesthetist
  • Macon, GA
  • NPI 1194381236

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• SG Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Lawrenceville, GA
  • NPI 1053750646

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Sweet Dreams Nurse Anesthesia of Georgia LLC

  • Certified Registered Nurse Anesthetist
  • Macon, GA
  • NPI 1003168923

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1942514609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403",
            "city": "DONALSONVILLE",
            "state": "GA",
            "postal_code": "39845",
            "telephone_number": "229-524-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 NORTH CUTHBERT STREET",
            "city": "COLQUITT",
            "state": "GA",
            "postal_code": "39837",
            "telephone_number": "229-220-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MAC",
        "middle_name": "BRADLEY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-04",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN168512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colquitt Pharmacy LLC
• Stamey Seleste Cook, FNP-C
• Cozy Corner Adult Day Center LLC
• Oneil Culver, MD
• Anand Dave, MD
• Ketan Desai, MD
• Dr and Associates Rehabilitation, LLC
• Charles J Fetner, CRNA
• Brandy Smith Floyd, PA
• Four C, LLC (Grow Drug Co)

• Certified Registered Nurse Anesthetist in Colquitt, GA
• Providers in Colquitt, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.