NPIMap

Organization Active NPI

Pullman Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Pullman, WA
National Provider Identifier
1023676004
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PULLMAN ANESTHESIA PLLC
Practice address
835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone
(801) 254-6316
NPI assigned
Jun 4, 2019
Last updated
Mar 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Authorized official

Name
Corey D Johnson, CRNANPI 1447235353
Title
President
Phone
(801) 254-6316

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

835 SE Bishop Blvd
Pullman, WA 99163-5512

Mailing address

PO Box 3810
Salt Lake City, UT 84110-3810
Phone (801) 254-6316

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1023676004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103810",
            "telephone_number": "801-254-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SE BISHOP BLVD",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635512",
            "telephone_number": "801-254-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULLMAN ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-254-6316",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.