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MRS. TABETHA BROOME RENNER PA-AC NPI 1487810610


NPI Information

NPI: 1487810610
Provider Name: MRS. TABETHA BROOME RENNER, PA-AC
Classification: Anesthesiologist Assistant - 367H00000X
Entity Type: Individual
Address:
400 CHARTER BLVD
MACON, GA
ZIP 31210
Phone: (478) 746-7577
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MRS. Tabetha Broome Renner, PA-AC is an anesthesiologist assistant in Macon, GA with 16 years of experience. The provider is 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. MRS. Tabetha Broome Renner, PA-AC NPI is 1487810610. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2008

The provider's business location address is:

400 CHARTER BLVD
MACON, GA
ZIP 31210-831
Phone: (478) 746-7577

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:00731)
  • Anesthesia for procedure in upper abdomen including use of an endoscope (HCPCS:00790)

The enumeration date for this NPI number is 8/7/2008 and was last updated on 4/13/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1367H00000XAnesthesiologist AssistantNo
2367H00000XAnesthesiologist Assistant05414GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1580628385OTHERGEORGIATRICARE
2P01101055OTHERGEORGIARAILROAD MEDICARE
3606097755EMEDICAIDGEORGIA
4578310OTHERGEORGIAWELLCARE
5606097755GMEDICAIDGEORGIA
6606097755FMEDICAIDGEORGIA
7606097755DMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.