NPIMap

Organization Active NPI

Patriot Anesthesia LLC

  • Anesthesiology Physician
  • Hinesville, GA
National Provider Identifier
1952840449
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PATRIOT ANESTHESIA LLC
Practice address
462 Elma G Miles Pkwy
Hinesville, GA 31313-4000
Phone
(912) 369-9400
NPI assigned
Feb 16, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Authorized official

Name
William D King
Title
President
Phone
(352) 381-5413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X GA Primary

Addresses

Primary practice location

462 Elma G Miles Pkwy
Hinesville, GA 31313-4000

Mailing address

7956 Vaughn Rd # 165
Montgomery, AL 36116-6625
Phone (888) 829-0068

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170501001250 GA Part B Supplier - Clinic/Group Practice 0840577888 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
Practice locations: Hinesville, GA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Hospital Authority of Liberty County3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1952840449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7956 VAUGHN RD # 165",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361166625",
            "telephone_number": "888-829-0068",
            "fax_number": "334-239-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 ELMA G MILES PKWY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134000",
            "telephone_number": "912-369-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRIOT ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-16",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-381-5413"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.