Active NPI
Charles David Laine, CRNA
- Certified Registered Nurse Anesthetist
- Tempe, AZ
National Provider Identifier
1003911520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN083051
- Practice address
- 1500 S Mill Ave
Tempe, AZ 85281-6699 - Phone
- (480) 784-5500
- NPI assigned
- Sep 13, 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 | RN083051 | AZ | Primary |
Addresses
Primary practice location
1500 S Mill Ave
Tempe, AZ 85281-6699
Mailing address
862 N Pineview Dr
Chandler, AZ 85226-1919
Phone (480) 940-3895
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinical Partners PA | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Care for Kids of Arizona | Past | Accepting new patients | |
| Squaw Peak Anesthesia Inc | Past | Accepting new patients | |
| Squaw Peak Anesthesia Inc | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003911520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "862 N PINEVIEW DR",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852261919",
"telephone_number": "480-940-3895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 S MILL AVE",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852816699",
"telephone_number": "480-784-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAINE",
"first_name": "CHARLES",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AZ",
"license": "RN083051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.