| Katelyn E Longacre, CRNA | |
|
1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | |
| (770) 702-1806 | |
| (770) 693-0810 |
| Full Name | Katelyn E Longacre |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 12 Years |
| Location | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, Georgia |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194161158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN9292268 (Florida) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | RN311144 (Georgia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mak Anesthesia Holdings, Llc | 4284917204 | 169 |
| Atlanta Anesthesia Consultants Llc | 4486818093 | 17 |
| Wellstar Medical Group Llc | 6709065402 | 2734 |
| Mak Anesthesia Georgia, Llc | 7315203718 | 92 |
| Entity Name | American Anesthesiology Associates Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528068673 PECOS PAC ID: 7618934779 Enrollment ID: O20041210000442 |
| Entity Name | Greater Anesthesia Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518128289 PECOS PAC ID: 7810064029 Enrollment ID: O20080930000033 |
| Entity Name | Mulkey Anesthesiology Associates, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417288069 PECOS PAC ID: 6406035583 Enrollment ID: O20110120001157 |
| Entity Name | Wellstar Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
| Entity Name | Atlanta Hand Specialist Surgery Center Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1285912923 PECOS PAC ID: 5890952410 Enrollment ID: O20120208000844 |
| Entity Name | Ahs Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316214604 PECOS PAC ID: 7911169925 Enrollment ID: O20120508000359 |
| Entity Name | Atlanta Anesthesia Consultants Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487928370 PECOS PAC ID: 4486818093 Enrollment ID: O20120612000168 |
| Entity Name | Ahs Surgery Center Canton, Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1225457948 PECOS PAC ID: 6103043377 Enrollment ID: O20140812000706 |
| Entity Name | Carpus Surgery Center Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1568864452 PECOS PAC ID: 4688994387 Enrollment ID: O20150520002165 |
| Entity Name | Perimeter Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922402445 PECOS PAC ID: 2567763048 Enrollment ID: O20151229001858 |
| Entity Name | Radius Surgery Center Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1215302906 PECOS PAC ID: 1456644244 Enrollment ID: O20160802000541 |
| Entity Name | Mak Anesthesia Holdings, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912452939 PECOS PAC ID: 4284917204 Enrollment ID: O20170216001563 |
| Entity Name | Ulna Surgery Center Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1881147965 PECOS PAC ID: 8729356977 Enrollment ID: O20170613001165 |
| Entity Name | Mak Anesthesia Northside Affiliates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609390103 PECOS PAC ID: 7315203718 Enrollment ID: O20171116002499 |
| Entity Name | Csp Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568946812 PECOS PAC ID: 6901147206 Enrollment ID: O20190415002910 |
| Entity Name | Lunate Surgery Center |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1932709490 PECOS PAC ID: 8022427681 Enrollment ID: O20210511002620 |
| Mailing Address | Practice Location Address |
|---|---|
| Katelyn E Longacre, CRNA 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 Ph: (770) 702-1806 | Katelyn E Longacre, CRNA 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 Ph: (770) 702-1806 |
Laura Uphouse, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1640 Airport Rd Nw, Ste 110, Kennesaw, GA 30144 Phone: 678-202-2074 Fax: 770-590-1442 | |
Daisy Tambe Jean-pierre, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152 Phone: 770-702-1806 | |
Jenny R Deforeest, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1640 Airport Rd Nw, Ste. 110, Kennesaw, GA 30144 Phone: 678-202-2074 Fax: 678-290-0479 | |
Lauren Turley, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5003 Barnwood Ter Nw, Kennesaw, GA 30152 Phone: 404-542-0285 | |
Paul Christopher Dozier, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1640 Airport Rd Nw, Ste 110, Kennesaw, GA 30144 Phone: 678-202-2074 | |
Sarah Jordan Kabase, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152 Phone: 770-702-1806 |