Individual provider Active NPI

Audrey Avila, M.D.

  • Anesthesiology Physician
  • Gainesville, GA
National Provider Identifier
1982137899
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
88127 Issued in GA
Practice address
1488 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3803
Phone
(941) 376-2020
NPI assigned
Apr 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 88127 GA Primary

Addresses

Primary practice location

1488 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3803

Mailing address

5996 Scenic Rd
Gainesville, GA 30506-2479
Phone (941) 376-2020

Other practice location 1

625 19th Street South
Birmingham, AL 35249
Phone (205) 934-6525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210526002435 GA Practitioner - Anesthesiology 8022395011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Gainesville, LLC 149 clinicians

Practice addresses (Care Compare)

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 532-7179

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulatory Anesthesia of North Georgia, LLC Anesthesiology CurrentSince Jul 26, 2021 Accepting new patients
Anesthesia Associates of Gainesville, LLC Anesthesiology CurrentSince Jul 26, 2021 Accepting new patients

Locations

1524 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 532-7092

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

1488 Jesse Jewell Pkwy SE
Ste 201
Gainesville, GA 30501
Phone (678) 253-0175

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1982137899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5996 SCENIC RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305062479",
            "telephone_number": "941-376-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013803",
            "telephone_number": "941-376-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th Street South",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "35249",
            "country_code": "US",
            "telephone_number": "205-934-6525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVILA",
        "first_name": "AUDREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "88127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.