DR. JERRY TEE TODD (NPI# 1699041863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699041863 |
| Entity Type | Individual |
| Full Name | DR. JERRY TEE TODD |
| Credential | M.D. |
| Practice Address |
1300 Ridenour Blvd Nw Ste 300 Kennesaw GA 30152-4402 |
| Mailing Address |
3999 Matty Dr Ne Marietta GA 30066-1113 |
| Practice Telephone | 7706344215 |
| Mailing Telephone | 7706344215 |
| Enumeration Date | 2012-03-31 |
| Last Update Date | 2020-03-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | MD.35302 | AL | Allopathic & Osteopathic Physicians |
| Y | 207L00000X | Anesthesiology | 76501 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1300 RIDENOUR BLVD NW STE 300 |
| City | KENNESAW |
| State | GA |
| Zip Code | 30152-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376785600 | Grant Adam Doornbos | Anesthesiology | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | 2009-04-01 |
| 1134778939 | Kaeli Surilla Mcdermott | Anesthesiologist Assistant | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | 2019-09-05 |
| 1619449618 | Whitney Nicole Snow | Nurse Practitioner | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | 2019-01-02 |
| 1609390103 | Mak Anesthesia Northside Affiliates, LLC | Anesthesiology | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | 2017-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821647124 | Ashley Dover | Nurse Practitioner | 1300 Ridenour Blvd, Suite 300, Kennesaw, GA 30152 | 2019-09-09 |
| 1205306891 | Lashanda Denise Moore | Nurse Practitioner | 1600 Kennesaw Due West Rd Nw #205, Kennesaw, GA 30152 | 2018-11-27 |
| 1265901094 | Focused Loving Home Care Services LLC | In Home Supportive Care | 2151 Marne Glen Nw, Kennesaw, GA 30152 | 2018-11-22 |
| 1083199152 | Raven Ashley Thomas | Behavioral Analyst | 1619 Collins Rd Nw Ste 500, Kennesaw, GA 30152 | 2018-09-25 |
| 1821592593 | Eseovhe Egborge PC | Clinic/Center | 1600 Kennesaw Due West Rd Nw Ste 205, Kennesaw, GA 30152 | 2018-03-19 |
| 1184143059 | Kennesaw Mountain Dental Associates | Dentist | 1815 Old 41 Hwy, Ste 310, Kennesaw, GA 30152 | 2017-09-12 |
| 1265955983 | Deborah Ruth Stern Compton | Registered Nurse | 1291 Stanley Rd., Kennesaw, GA 30152 | 2017-07-25 |
| 1912452939 | Mak Anesthesia Holdings LLC | Anesthesiology | 1300 Ridenour Blvd., Ste. 300, Kennesaw, GA 30152 | 2016-08-19 |
| 1528430279 | Tineka Nichol Wyckoff | Counselor | 1967 Lake Heights Circle, Kennesaw, GA 30152 | 2015-10-21 |
| 1669753992 | American Current Care Pa | Clinic/Center | 2953 Cobb Parkway, Suite 400, Kennesaw, GA 30152 | 2011-08-31 |
| Find all providers in zip 30152 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912452939 | Mak Anesthesia Holdings LLC | Anesthesiology | 1300 Ridenour Blvd., Ste. 300, Kennesaw, GA 30152 | 2016-08-19 |
| 1386028744 | Mak Anesthesia, LLC | Anesthesiology | 1621 N Roberts Rd Nw Ste 110, Kennesaw, GA 30144-3640 | 2015-07-16 |
| 1437579042 | James Michael Ditolla | Anesthesiology | 1275 Shiloh Rd Nw Ste 2120, Kennesaw, GA 30144-7199 | 2014-04-22 |
| 1558672782 | Isabella Zita Ricketts | Anesthesiology | 1300 Ridenour Blvd Nw, Mak Anesthesia, Kennesaw, GA 30152-4501 | 2010-06-22 |
| 1376785600 | Grant Adam Doornbos | Anesthesiology | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | 2009-04-01 |
| 1609390103 | Mak Anesthesia Northside Affiliates, LLC | Anesthesiology | 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152-4402 | 2017-07-27 |
| 1417402942 | Sculptrx Inc | Anesthesiology | 125 Townpark Dr Nw, Ste 300, Kennesaw, GA 30144-5803 | 2016-08-25 |
| 1245632660 | Wellstar Medical Group, LLC | Anesthesiology | 1180 Ernest W Barrett Pkwy Nw, Suite 100, Kennesaw, GA 30144-4534 | 2014-09-17 |
| 1013046374 | Russell H Blocker | Anesthesiology | 1640 Airport Rd Nw, Ste. 110, Kennesaw, GA 30144-7038 | 2007-03-05 |
| 1245369784 | Jenny R Deforeest | Anesthesiology | 1640 Airport Rd Nw, Ste. 110, Kennesaw, GA 30144-7038 | 2007-03-02 |
| Find all providers in KENNESAW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.