Active NPI
Steven Derek Ceola, CRNA
- Certified Registered Nurse Anesthetist
- Rogers, AR
National Provider Identifier
1023078318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- CO1037
- Practice address
- 2710 Rife Medical LN
Rogers, AR 72758-1452 - Phone
- (913) 381-5200
- Fax
- (913) 381-0979
- NPI assigned
- Mar 23, 2006
- Sex
- Male
- Sole proprietor
- No
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 | CO1037 | AR | Primary |
Addresses
Primary practice location
2710 Rife Medical LN
Rogers, AR 72758-1452
Mailing address
PO Box 507
Lowell, AR 72745-0507
Phone (913) 381-5200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 913903126 | Medicaid | MO | |
| 134918701 | Medicaid | AR |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO1037 | AR | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283385600000",
"number": "1023078318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 507",
"city": "LOWELL",
"state": "AR",
"postal_code": "727450507",
"telephone_number": "913-381-5200",
"fax_number": "913-381-0979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 RIFE MEDICAL LN",
"city": "ROGERS",
"state": "AR",
"postal_code": "727581452",
"telephone_number": "913-381-5200",
"fax_number": "913-381-0979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CEOLA",
"first_name": "STEVEN",
"middle_name": "DEREK",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2010-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AR",
"license": "CO1037",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "913903126",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "134918701",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.