Individual provider Active NPI

Lourdes Sofia Avinaz, CRNA

  • Certified Registered Nurse Anesthetist
  • Garden City, KS
National Provider Identifier
1033551981
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
43557567122 Issued in KS
Practice address
401 E Spruce St
Garden City, KS 67846-5679
Phone
(620) 272-2222
NPI assigned
Jul 19, 2013
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN9331281 FL
Certified Registered Nurse Anesthetist 367500000X 43557567122 KS Primary

Addresses

Primary practice location

401 E Spruce St
Garden City, KS 67846-5679

Mailing address

PO Box 178
Garden City, KS 67846-0178
Phone (904) 729-9614

Other practice location 1

655 W 8th St
Jacksonville, FL 32209-6511
Phone (904) 244-8649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190606002600 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214298736 Reassigns benefits to 1 organization
I20240430002090 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214298736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tucson Physician Group Holdings LLCGroup PAC ID 0547560070, 200 clinicians

Practice addresses (Care Compare)

1601 W Saint Marys Rd
Tucson, AZ 85745-2623
Phone (520) 872-3000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9331281FLMDCritical Care Medicine Registered Nurse
43557567122KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Otero County Hospital Association CurrentSince Jun 3, 2019 Accepting new patients
Otero County Hospital Association CurrentSince Jun 3, 2019 Accepting new patients

Locations

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1033551981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 178",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678460178",
            "telephone_number": "904-729-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E SPRUCE ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465679",
            "telephone_number": "620-272-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-8649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVINAZ",
        "first_name": "LOURDES",
        "middle_name": "SOFIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN9331281",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "43557567122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.