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MR. JONATHAN DAVID DERRYBERRY JR. CAA
NPI 1831779578
Anesthesiologist Assistant in Rome, GA

Active since April 08, 2021
304 TURNER MCCALL BLVD SW, ROME, GA 30165(404) 727-5910 Get Directions Write a Review

NPPES record last updated: December 15, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 15, 2022, Apr 8, 2021 (2 updates tracked since 2021).

About Mr. Jonathan David Derryberry Jr. Caa NPPES

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

MR. JONATHAN DAVID DERRYBERRY JR. CAA (NPI 1831779578) is an individual anesthesiologist assistant in Rome, Georgia and active in the NPI registry since April 2021. He is affiliated with Atrium Health Floyd Medical Center and is a graduate of Emory University School Of Medicine (2022).

NPPES Registry Identity

NPI1831779578
Entity TypeIndividualMale
Primary Taxonomy367H00000X
Provider Legal NameMR. JONATHAN DAVID DERRYBERRY JR.Credential: CAA
Location Address304 TURNER MCCALL BLVD SWRome, GA 30165-5621
Mailing Address304 Turner Mccall Blvd SwRome, GA 30165-5621
Phone(404) 727-5910
Sole ProprietorNo
Medical School CMSEmory University School Of MedicineGraduated 2022
Enumeration DateApril 8, 2021
Last NPPES UpdateDecember 15, 20222 updates tracked since enumeration
NPPES CertifiedDecember 15, 2022
✔ NPI 1831779578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367H00000X
Definition

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.

304 TURNER MCCALL BLVD SW, Rome, GA 30165
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Jonathan David Derryberry Jr. Caa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3678945714
PECOS Enrollment IDI20230217001966

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Atrium Health Floyd Medical Center

Acute Care Hospitals · Rome, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110054
Location304 Turner Mccall BoulevardRome, GA 30162 · Floyd County
Birthing friendly

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.

KRISTOFER RYAN FOREMAN P.A.
Physician Assistant (Medical)
304 TURNER MCCALL BLVD SW
ROME, GA 30165
Floyd County (706) 509-5000
WILLIAM M GARNER N.P.
Nurse Practitioner (Family)
304 TURNER MCCALL BLVD SW
ROME, GA 30165
Floyd County (706) 509-5000
JILL G POTTINGER M.D.
Emergency Medicine
304 TURNER MCCALL BLVD SW
ROME, GA 30165
Floyd County (706) 509-6122
DEWEY HAMMOND III M.D.
Emergency Medicine
304 TURNER MCCALL BLVD SW
ROME, GA 30165
Floyd County (706) 509-6122
JAMES D POTTINGER JR. P.A.
Physician Assistant (Medical)
304 TURNER MCCALL BLVD SW
ROME, GA 30165
Floyd County (706) 509-6122
JOHN KEVIN HARDWELL M.D.
Emergency Medicine
304 TURNER MCCALL BLVD SW
ROME, GA 30165
Floyd County (706) 509-6122
GEORGE E MALCOM JR. M.D.
Emergency Medicine
304 TURNER MCCALL BLVD SW
ROME, GA 30165
Floyd County (706) 509-6122
JENNIFER M GOLDBACH P.A.
Physician Assistant (Medical)
304 TURNER MCCALL BLVD SW
ROME, GA 30165
Floyd County (706) 509-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Derryberry's NPI number?

The NPI number for Jonathan Derryberry is 1831779578. It was assigned to this individual provider in the NPPES registry on April 8, 2021.

Where is Jonathan Derryberry located?

Jonathan Derryberry practices at 304 Turner Mccall Blvd SW, Rome, GA 30165. The listed phone number is (404) 727-5910.

What is Jonathan Derryberry's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Jonathan Derryberry enrolled in Medicare?

Yes. Jonathan Derryberry is registered in the Medicare PECOS enrollment system.

Is Jonathan Derryberry affiliated with any hospitals?

According to CMS data, Jonathan Derryberry is affiliated with Atrium Health Floyd Medical Center.

When was this NPI record last updated?

The NPPES record for Jonathan Derryberry was last updated on December 15, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.