FIRST SOURCE ANESTHESIA, LLC
NPI 1558728907
Nurse Anesthetist, Certified Registered in Macon, GA

Active since January 15, 2016
577 MULBERRY ST STE 110, MACON, GA 31201(888) 728-0882 Get Directions Write a Review

NPPES record last updated: August 14, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 14, 2020, Mar 28, 2016, Jan 15, 2016 (3 updates tracked since 2016).

About First Source Anesthesia, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FIRST SOURCE ANESTHESIA, LLC (NPI 1558728907) is a healthcare organization registered as a nurse anesthetist, certified registered in Macon, Georgia and active in the NPI registry since January 2016. The organization maintains a secondary practice location in Alpharetta and lists Richard Douberly, Member Manager, as its authorized official.

NPPES Registry Identity

NPI1558728907
Entity TypeOrganization
Primary Taxonomy367500000X
Legal Business NameFIRST SOURCE ANESTHESIA, LLC
Location Address577 MULBERRY ST STE 110Macon, GA 31201-8220
Mailing AddressPo Box 850001, Dept #249Orlanda, FL 32885-0249 · (888) 728-0882 · Fax (888) 512-1507
Organization SubpartNo
Authorized OfficialRichard DouberlyMember Manager · (888) 728-0882
Enumeration DateJanuary 15, 2016
Last NPPES UpdateAugust 14, 20203 updates tracked since enumeration
NPPES CertifiedAugust 14, 2020
NPI 1558728907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

577 MULBERRY ST STE 110, Macon, GA 31201

Secondary Practice Location 1

Location 14080 McGinnis Ferry Rd, Suite 102Alpharetta, GA 30005 · Phone (888) 728-0882 ext. 7 · Fax (888) 512-1507

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Anesthesiology
577 MULBERRY ST STE 110
MACON, GA 31201
Nurse Anesthetist, Certified Registered
577 MULBERRY ST STE 110
MACON, GA 31201
Nurse Anesthetist, Certified Registered
577 MULBERRY ST STE 110
MACON, GA 31201
Nurse Anesthetist, Certified Registered
577 MULBERRY ST STE 110
MACON, GA 31201
Nurse Anesthetist, Certified Registered
577 MULBERRY ST STE 110
MACON, GA 31201
Nurse Anesthetist, Certified Registered
577 MULBERRY ST STE 110
MACON, GA 31201
Nurse Anesthetist, Certified Registered
577 MULBERRY ST STE 110
MACON, GA 31201
Nurse Anesthetist, Certified Registered
577 MULBERRY ST STE 110
MACON, GA 31201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1558728907, enumerated as an "organization" on January 15, 2016.

The provider is located at 577 MULBERRY ST STE 110 MACON, GA 31201 and the phone number is (888) 728-0882.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.