Active NPI
Kenneth Colodne, AA
- Anesthesiologist Assistant
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- 003350
- Practice address
- 5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342-1701 - Phone
- (404) 851-7324
- Fax
- (404) 843-2627
- NPI assigned
- Jan 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 003350 | GA | Primary |
Addresses
Primary practice location
5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342-1701
Mailing address
5671 Peachtree Dunwoody Rd NE
Suite 530
Atlanta, GA 30342-5000
Phone (404) 257-1415
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00304796K | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101215000475 | GA | Practitioner - Anesthesiology Assistant | 0648467704 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology Assistant
- Education
- Emory University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Physician Specialists in Anesthesia, P.C.
Practice addresses (Care Compare)
5671 Peachtree Dunwoody Rd
Suite 800
Atlanta, GA 30342-5021
Phone (404) 257-1415
Hospital & facility affiliations
- Saint Joseph'S Hospital of Atlanta, Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Associate of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003350 | GA | MD | Anesthesiologist Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Specialists in Anesthesia, P.C. | Anesthesiologist Assistant | Current | Accepting new patients |
Locations
5671 Ptree Dunwoody Rd NE
Ste 530
Sandy Springs, GA 30342
Phone (404) 257-1415
5671 Ptree Dunwoody Rd NE
Ste 800
Sandy Springs, GA 30342
Phone (404) 257-1415
5665 Ptree Dunwoody Rd NE
Sandy Springs, GA 30342
Phone (678) 843-7001
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1316968662
Anesthesiologist Assistant, GA
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1679664395
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1992852271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5671 PEACHTREE DUNWOODY RD NE",
"address_2": "SUITE 530",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303425000",
"telephone_number": "404-257-1415",
"fax_number": "404-851-1649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5665 PEACHTREE DUNWOODY RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421701",
"telephone_number": "404-851-7324",
"fax_number": "404-843-2627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLODNE",
"first_name": "KENNETH",
"credential": "AA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "GA",
"license": "003350",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00304796K",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.