Active NPI
Charles Kenneth Leonard, CRNA
- Certified Registered Nurse Anesthetist
- Sunnyside, WA
National Provider Identifier
1003874629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 38956
- Practice address
- 1016 Tacoma Ave
Sunnyside Community Hospital
Sunnyside, WA 98944-2263 - Phone
- (509) 837-1500
- Fax
- (509) 837-1584
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 38956 | WA | Primary |
Addresses
Primary practice location
1016 Tacoma Ave
Sunnyside Community Hospital
Sunnyside, WA 98944-2263
Mailing address
PO Box 487
Mabton, WA 98935
Phone (509) 894-5559
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43762 | Other | L & I | |
| 9606591 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38956 | WA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284422400000",
"number": "1003874629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 487",
"city": "MABTON",
"state": "WA",
"postal_code": "98935",
"telephone_number": "509-894-5559",
"fax_number": "309-403-8642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 TACOMA AVE",
"address_2": "SUNNYSIDE COMMUNITY HOSPITAL",
"city": "SUNNYSIDE",
"state": "WA",
"postal_code": "989442263",
"telephone_number": "509-837-1500",
"fax_number": "509-837-1584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONARD",
"first_name": "CHARLES",
"middle_name": "KENNETH",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2010-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "38956",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L & I",
"identifier": "43762",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9606591",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sunnyside, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.