MEDICARE: NORTHERN GEORGIA ANESTHESIA ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician
2	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1568256394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN GEORGIA ANESTHESIA ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	3414 PEACHTREE RD NE STE 340
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1137
Country	:	US
Telephone Number	:	425-803-3885
Fax Number	:

Provider Business Practice Location Address
First Line	:	3280 HOWELL MILL RD NW STE T150
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-4123
Country	:	US
Telephone Number	:	404-355-3200
Fax Number	:

Authorized Official
Title or Position	:	VP OF RCM
Name	:	JEFF L PERRY
Credential	:
Telephone Number	:	502-418-4700

Provider Enumeration Date	:	04/07/2025
Last Update Date	:	07/23/2025

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