Paul B Sullivan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP30005473 Issued in WA

Practice address

1200 W Fairview St
Colfax, WA 99111-9552

Phone

(509) 926-1770

Fax

(509) 228-9542

NPI assigned

Aug 30, 2006

Last updated

Nov 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Whitman Anesthesia PS

  • Certified Registered Nurse Anesthetist
  • Colfax, WA
  • NPI 1891805214
  Authorized official Same address or phone
• Infectious Disease Clinic of Spokane

  • Infectious Disease Physician
  • Spokane, WA
  • NPI 1396785911
  NPD (past)
• Inland Anesthesia Services P S

  • Certified Registered Nurse Anesthetist
  • Spokane, WA
  • NPI 1003926304

  Nurse Anesthetist, Certified Registered

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1023128451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21980 E COUNTRY VISTA DR",
            "address_2": "STE 200",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990196025",
            "telephone_number": "509-926-1770",
            "fax_number": "509-228-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W FAIRVIEW ST",
            "city": "COLFAX",
            "state": "WA",
            "postal_code": "991119552",
            "telephone_number": "509-926-1770",
            "fax_number": "509-228-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PAUL",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30005473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9617499",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "912153623",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Simmons, DPM
• Govind Singh, M.D.
• Robert Terry Smith, D.D.S.
• Brenna St John
• Erin Nicole Startin, ATC/L, LMP
• Three Forks Orthopaedics PC
• Tick Klock Drug LLC (Tick Klock Drugs LLC)
• John Lyle Turner, DMD
• Valley Dental, Inc (Mint Condition Dental)
• Jaime Mellor Vantine, FNP-C

• Certified Registered Nurse Anesthetist in Colfax, WA
• Providers in Colfax, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.