Individual provider Active NPI

Douglas G Demmert, CRNA

  • Certified Registered Nurse Anesthetist
  • Spokane, WA
National Provider Identifier
1043289507
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP30002486 Issued in WA
Practice address
842 S Cowley St
Ste 3
Spokane, WA 99202-1234
Phone
(509) 939-3483
Fax
(509) 228-9542
NPI assigned
Mar 16, 2006
Last updated
Oct 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP30002486 WA Primary

Addresses

Primary practice location

842 S Cowley St
Ste 3
Spokane, WA 99202-1234

Mailing address

PO Box 8227
Spokane, WA 99203-0227
Phone (509) 939-3483

Other identifiers 1

IdentifierTypeStateIssuer
9625567MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090113000774 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436212750 Practice locations: Spokane, WA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP30002486WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Past Accepting new patients
Douglas G Demmert Crna Nurse Anesthetist, Certified Registered PastSince Oct 15, 1999 Accepting new patients

Organizations & group practices 2

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1043289507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8227",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992030227",
            "telephone_number": "509-939-3483",
            "fax_number": "509-228-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 S COWLEY ST",
            "address_2": "STE 3",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021234",
            "telephone_number": "509-939-3483",
            "fax_number": "509-228-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMMERT",
        "first_name": "DOUGLAS",
        "middle_name": "G",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30002486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9625567",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.