Khushbu Modi, | |
276 Harmony Lake Dr, Canton, GA 30115-4781 | |
(404) 488-5590 | |
Not Available |
Full Name | Khushbu Modi |
---|---|
Gender | Female |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 8 Years |
Location | 276 Harmony Lake Dr, Canton, 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 |
---|---|---|---|
1083166383 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | RN202188 (Georgia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Wellstar North Fulton Hospital | Roswell, GA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mak Anesthesia Holdings, Llc | 4284917204 | 170 |
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 | 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 |
Mailing Address | Practice Location Address |
---|---|
Khushbu Modi, 276 Harmony Lake Dr, Canton, GA 30115-4781 Ph: () - | Khushbu Modi, 276 Harmony Lake Dr, Canton, GA 30115-4781 Ph: (404) 488-5590 |
Morgan Maeger, Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 1032 Forest Creek Dr, Canton, GA 30115 Phone: 770-367-3955 | |
Brent H. Suddeth, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 201 Hospital Rd, Anesthesia Dept, Canton, GA 30114 Phone: 404-851-6500 Fax: 770-237-1124 | |
Carla D Porche, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 201 Hospital Rd, Anesthesia Dept, Canton, GA 30114 Phone: 404-851-6500 Fax: 770-237-1124 | |
James Michael Rutherford, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 201 Hospital Rd, Canton, GA 30114 Phone: 770-720-5100 Fax: 770-720-4508 | |
Marni Elizabeth Daniel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 201 Hospital Rd, Canton, GA 30114 Phone: 770-720-5100 Fax: 770-720-4508 | |
Kimberle J Hickey, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 201 Hospital Rd, Anesthesia Department, Canton, GA 30114 Phone: 404-851-6500 Fax: 770-237-1124 |