Individual provider Active NPI

Bethany Peattie, CRNA

  • Certified Registered Nurse Anesthetist
  • Manchester, NH
National Provider Identifier
1023316122
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0582311-23 Issued in NH
Practice address
100 McGregor St
Manchester, NH 03102-3730
Phone
(603) 668-3545
Fax
(434) 517-3021
NPI assigned
Mar 14, 2011
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024169277 VA
Certified Registered Nurse Anesthetist 367500000X 0582311-23 NH Primary

Addresses

Primary practice location

100 McGregor St
Manchester, NH 03102-3730

Mailing address

13809 Research Blvd Ste 500
Austin, TX 78750-1223
Phone (919) 904-0310

Other identifiers 2

IdentifierTypeStateIssuer
0582311-23MedicaidNH
002469277OtherVALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NC, NH, NM4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20170502000046 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335327907 Reassigns benefits to 3 organizations
I20200706001285 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335327907 Reassigns benefits to 2 organizations
I20200930002177 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335327907 Reassigns benefits to 1 organization
I20210819001218 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335327907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

800 N Justice St
Hendersonville, NC 28791-3410
Phone (828) 696-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
6350NCMDGeneral Practice Dentistry
0582311-23NHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2022 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mission Health Community Multispecialty Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince May 26, 2020 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2023 Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince May 26, 2020 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2022 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesia Care Group PC CurrentSince Jul 25, 2020 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 2, 2024 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 17, 2023 Accepting new patients
Netherlands Anesthesia, LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

800 N Justice St
Hendersonvlle, NC 28791
Phone (828) 696-1000

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

88 McGregor St
Ste 303
Manchester, NH 03102
Phone (603) 647-9325

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

12850 Toepperwein Rd
Live Oak, TX 78233
Phone 2106141234713

5223 Hamilton Wolfe Rd
San Antonio, TX 78229
Phone 2106141234713

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

855 Proton Rd
San Antonio, TX 78258
Phone (210) 582-8000

9725 Datapoint Dr
Ste 136
San Antonio, TX 78229
Phone (210) 455-1595

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1023316122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13809 RESEARCH BLVD STE 500",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501223",
            "telephone_number": "919-904-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MCGREGOR ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023730",
            "telephone_number": "603-668-3545",
            "fax_number": "434-517-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEATTIE",
        "first_name": "BETHANY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-14",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024169277",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "0582311-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0582311-23",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "002469277",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.