Platinum Anesthesia Coastal, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

PLATINUM ANESTHESIA COASTAL, LLC

Practice address

200 N River St
Dept of Anesthesia
Claxton, GA 30417-1659

Phone

(912) 739-5000

NPI assigned

Mar 3, 2009

Last updated

Sep 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Atkinson

Title

Director

Phone

(800) 605-9961

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1972743987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "TENNILLE",
            "state": "GA",
            "postal_code": "310890068",
            "telephone_number": "800-605-9961",
            "fax_number": "800-782-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N RIVER ST",
            "address_2": "DEPT OF ANESTHESIA",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171659",
            "telephone_number": "912-739-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM ANESTHESIA COASTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "ATKINSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "800-605-9961"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "568167122A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DO7086",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Joshua Robert Pacut, PA
• Hugh Kyle Parks, M.D.
• Ryan W Piche, OD
• Tayler Leeann Poole
• Premise Health of Georgia Medical PC (Claxton Poultry Wellness Center)
• Lutrenda Renelus
• Lafils Ann Rivers
• Jesse B Scott, MD

• Certified Registered Nurse Anesthetist in Claxton, GA
• Providers in Claxton, 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 Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.