JACK LEE SUDDRETH (CRNA) – Certified Registered Nurse Anesthetist, NPI 1083676274
Preparing for Medicare enrollment?
Use our CMS-855 prep checklist: which form applies (855I, 855O, or 855A), readiness score, NPPES field map, and Section 12 documents. Reassignment uses CMS-855I Section 4F—not the discontinued CMS-855R form.
Open Medicare 855 Prep tool →Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for JACK LEE SUDDRETH (CRNA)
Rice Box, Atlanta BeltLine Eastside Trail, Atlanta, Georgia, 30308, United States
DEPT 1041
ATLANTA, GA 303740209
Phone: (941) 360-1566
Fax: (941) 358-9818
Type: Mailing
801, South Adams Street, Petersburg, Virginia, 23803, United States
PETERSBURG, VA 238082938
Phone: (804) 862-5000
Fax: (804) 862-5948
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30374)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| - | GA | |
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| Anesthesiology, Pain Management | FL | |
| - | AL | |
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| A N E S T H E S I O L O G Y | IN | |
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| Certified Registered Nurse Anesthetist (Crna) | AL |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.