Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jake Lane

Individual provider Anesthesiologist Assistant · NPI 1417506304

Jake Lane is an Anesthesiology Assistant in Marietta, Georgia. Qualified in 2019, 7 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group and works from 4 locations.

Years since qualifying
7
In the registry since
2019
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Practice location Address checks out

677 Church St NE
Marietta, GA 30060-1101
Phone: (770) 794-0477
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 8954 Hospital Dr, Douglasville, GA 30134-2272 — (770) 794-0477
  • 146 Bill Carruth Pkwy, Hiram, GA 30141-3749 — (770) 794-0477
  • 2540 Windy Hill Rd Se, Marietta, GA 30067-8605 — (770) 794-0477

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X

Record details

NPI number1417506304
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 4, 2019
Last updated in NPPESSeptember 24, 2019
Mailing address531 Roselane St Nw Ste 830, Marietta, GA 30060-6979

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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