Kadasha Fairclough, RN is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Loganville, Georgia. She graduated from nursing school in 2024 and has 1 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Northstar Anesthesia Of Virginia, Llc and her current practice location is
1340 Alexander Xing, Loganville, Georgia. You can reach out to her office (for appointments etc.) via phone at
(404) 916-9226.
Kadasha Fairclough is licensed to practice in Virginia (license number 0024190568) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1184260275.
Provider's Profile
| Full Name | Kadasha Fairclough |
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| Gender | Female |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 1 Years |
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| Location | 1340 Alexander Xing, Loganville, Georgia |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kadasha Fairclough graduated from nursing school in 2024
NPI Data:
- NPI Number: 1184260275
- Provider Enumeration Date: 11/23/2019
- Last Update Date: 12/06/2024
Medicare PECOS Information:
- PECOS PAC ID: 4284160169
- Enrollment ID: I20241216003099
Medical Identifiers
Medical identifiers for Kadasha Fairclough such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1184260275 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | RN286337 (Georgia) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 0024190568 (Virginia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Northstar Anesthesia Of Virginia, Llc | 6608268826 | 372 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kadasha Fairclough allows following entities to bill medicare on her behalf.
| Entity Name | Northstar Anesthesia Of Virginia, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1194488791
PECOS PAC ID: 6608268826
Enrollment ID: O20220120002585 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kadasha Fairclough is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kadasha Fairclough, RN
1340 Alexander Xing,
Loganville, GA 30052-3985
Ph: (404) 916-9226 | Kadasha Fairclough, RN
1340 Alexander Xing,
Loganville, GA 30052-3985
Ph: (404) 916-9226 |
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