KAELI SURILLA MCDERMOTT (NPI# 1134778939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134778939 |
| Entity Type | Individual |
| Full Name | KAELI SURILLA MCDERMOTT |
| Practice Address |
1300 Ridenour Blvd Nw Ste 300 Kennesaw GA 30152-4402 |
| Mailing Address |
21 Sherman Ln Nw Cartersville GA 30121-4957 |
| Practice Telephone | 7707021806 |
| Mailing Telephone | 6789823914 |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1300 RIDENOUR BLVD NW STE 300 |
| City | KENNESAW |
| State | GA |
| Zip Code | 30152-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376785600 | Grant Adam Doornbos | Anesthesiology | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | 2009-04-01 |
| 1619449618 | Whitney Nicole Snow | Nurse Practitioner | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | 2019-01-02 |
| 1609390103 | Mak Anesthesia Northside Affiliates, LLC | Anesthesiology | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | 2017-07-27 |
| 1699041863 | Jerry Tee Todd | Anesthesiology | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | 2012-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821647124 | Ashley Dover | Nurse Practitioner | 1300 Ridenour Blvd, Suite 300, Kennesaw, GA 30152 | 2019-09-09 |
| 1205306891 | Lashanda Denise Moore | Nurse Practitioner | 1600 Kennesaw Due West Rd Nw #205, Kennesaw, GA 30152 | 2018-11-27 |
| 1265901094 | Focused Loving Home Care Services LLC | In Home Supportive Care | 2151 Marne Glen Nw, Kennesaw, GA 30152 | 2018-11-22 |
| 1083199152 | Raven Ashley Thomas | Behavioral Analyst | 1619 Collins Rd Nw Ste 500, Kennesaw, GA 30152 | 2018-09-25 |
| 1821592593 | Eseovhe Egborge PC | Clinic/Center | 1600 Kennesaw Due West Rd Nw Ste 205, Kennesaw, GA 30152 | 2018-03-19 |
| 1184143059 | Kennesaw Mountain Dental Associates | Dentist | 1815 Old 41 Hwy, Ste 310, Kennesaw, GA 30152 | 2017-09-12 |
| 1265955983 | Deborah Ruth Stern Compton | Registered Nurse | 1291 Stanley Rd., Kennesaw, GA 30152 | 2017-07-25 |
| 1912452939 | Mak Anesthesia Holdings LLC | Anesthesiology | 1300 Ridenour Blvd., Ste. 300, Kennesaw, GA 30152 | 2016-08-19 |
| 1528430279 | Tineka Nichol Wyckoff | Counselor | 1967 Lake Heights Circle, Kennesaw, GA 30152 | 2015-10-21 |
| 1669753992 | American Current Care Pa | Clinic/Center | 2953 Cobb Parkway, Suite 400, Kennesaw, GA 30152 | 2011-08-31 |
| Find all providers in zip 30152 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134485972 | Charles Luther | Anesthesiologist Assistant | 4295 Country Garden Walk Nw, Kennesaw, GA 30152-2399 | 2012-04-05 |
| 1053308601 | Tiffany L. Artman | Anesthesiologist Assistant | 1640 Airport Rd Nw, Ste110, Kennesaw, GA 30144-7038 | 2005-09-29 |
| 1992257943 | Mark Fouts | Anesthesiologist Assistant | 1621 N Roberts Rd Nw Ste 110, Kennesaw, GA 30144-3640 | 2016-10-25 |
| 1346465127 | Gary P Jones | Anesthesiologist Assistant | 1640 Airport Rd Nw, Ste 110, Kennesaw, GA 30144-7038 | 2007-04-16 |
| 1093734428 | Donald Macneill | Anesthesiologist Assistant | 1640 Airport Rd Nw, Ste 110, Kennesaw, GA 30144-7038 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639784119 | Caroline N/a Guan | Anesthesiologist Assistant | 1377 Dresden Dr Ne Apt 5117, Brookhaven, GA 30319-3457 | 2020-09-11 |
| 1841815925 | Ghazal Motakef | Anesthesiologist Assistant | 365 Victorian Ln, Johns Creek, GA 30097-5769 | 2020-06-14 |
| 1801446455 | Mednax | Anesthesiologist Assistant | 770 Pine St Ste L40, Macon, GA 31201-7521 | 2019-09-16 |
| 1114570553 | Diana Ansley Berry | Anesthesiologist Assistant | 531 Roselane St Nw Ste 830, Marietta, GA 30060-6979 | 2019-07-23 |
| 1346703758 | Alexander Lee | Anesthesiologist Assistant | 1228 Christiana Xing, Lawrenceville, GA 30043-7007 | 2019-04-11 |
| 1710449897 | Salman Noorali Dewani | Anesthesiologist Assistant | 6371 Crestgate Ln, Tucker, GA 30084-8458 | 2019-04-05 |
| 1316432537 | Heather Mcintyre | Anesthesiologist Assistant | 57 Executive Park S Ste 300, Atlanta, GA 30329-2287 | 2018-06-29 |
| 1699292235 | Robin Spierer | Anesthesiologist Assistant | 80 Jesse Hill Jr Dr Se # 6d028, Atlanta, GA 30303-3031 | 2017-08-24 |
| 1821512401 | Stephen Chaussinand | Anesthesiologist Assistant | 5673 Peachtree Dunwoody Rd Ste 490, Atlanta, GA 30342-1775 | 2017-07-26 |
| 1790206381 | Andres Felipe Hernandez | Anesthesiologist Assistant | 80 Jesse Hill Jr Dr Se Ste 6d028, Atlanta, GA 30303-3031 | 2017-07-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.