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General NPI Number Information
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NPI Number | 1962399865
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Entity Type | Organization
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Legal Business Name | PIEDMONT SEDATION ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 1901 S HAWTHORNE RD STE 308
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3914
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Country | US
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Telephone | 336-901-9155
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Fax |
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Provider Business Mailing Address
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Address Line | 3414 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30326-1153
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Country | US
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Telephone | 425-803-3885
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JAMES KREGER
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Credential |
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Telephone | 205-999-4132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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