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

Mr. Jonathan David Derryberry Jr., CAA

Individual provider Anesthesiologist Assistant · NPI 1831779578

Mr. Jonathan David Derryberry Jr., CAA is an Anesthesiology Assistant in Rome, Georgia. Graduated from Emory University School of Medicine in 2022, 4 years ago. Practices with Mak Anesthesia Georgia, LLC, a 107-clinician group.

Years since qualifying
4
Trained at
Emory University School of Medicine
In the registry since
2021
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

304 Turner McCall Blvd SW
Rome, GA 30165-5621
Phone: (404) 727-5910
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X

Record details

NPI number1831779578
Entity typeIndividual (Type 1)
GenderMale
Credentials CAA
Sole proprietorNo
NPI enumeratedApril 8, 2021
Last updated in NPPESDecember 15, 2022
Certification dateDecember 15, 2022

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolEMORY UNIVERSITY SCHOOL OF MEDICINE
Graduated 2022 (4 years in practice)
Group practice Mak Anesthesia Georgia, Llc — 107 clinicians
Accepts Medicare assignment Not indicated

Other providers in Rome