Individual provider Active NPI

Ann Loeffler Palenshus, CRNA

  • Certified Registered Nurse Anesthetist
  • Ridgefield, WA
National Provider Identifier
1063521235
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP30003999 Issued in WA
Practice address
17111 NW 69TH Ave
Ridgefield, WA 98642-9030
Phone
(360) 989-4077
NPI assigned
Aug 30, 2006
Last updated
May 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 096006546 OR
Certified Registered Nurse Anesthetist 367500000X 245585 TX
Certified Registered Nurse Anesthetist 367500000X 19775 SC
Certified Registered Nurse Anesthetist 367500000X AP30003999 WA Primary

Addresses

Primary practice location

17111 NW 69TH Ave
Ridgefield, WA 98642-9030

Mailing address

17111 NW 69TH Ave
Ridgefield, WA 98642-9030
Phone (360) 989-4077

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151210001158 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476642174 Reassigns benefits to 1 organization
I20191107000336 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476642174 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
096006546ORMDCertified Registered Nurse Anesthetist
19775SCMDCertified Registered Nurse Anesthetist
245585TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Anesthesia Services LLC CurrentSince Mar 10, 2020 Accepting new patients
Anesthesia Partners & Management LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2019 Accepting new patients
Southeast Anesthesiology Consultants, PLLC CurrentSince Oct 14, 2015 Accepting new patients
Southeast Anesthesiology Consultants, PLLC CurrentSince Oct 14, 2015 Accepting new patients
Metrowest Anesthesia Care, PLLC PastSince Jul 1, 2016 Accepting new patients
Metropolitan Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1020 N San Francisco St
Ste 100
Flagstaff, AZ 86001
Phone (928) 774-2300

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

3900 E Camelback Rd
Ste 190
Phoenix, AZ 85018
Phone (888) 724-6236

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

7301 N 16th St
Ste 102
Phoenix, AZ 85020
Phone (602) 772-8600

3110 Clearwater Dr
Prescott, AZ 86305
Phone (623) 241-6185

5430 Distinction Way
Prescott, AZ 86301
Phone (928) 445-1919

1704 W Anklam Rd
Ste 108
Tucson, AZ 85745
Phone (623) 241-6185

7566 N La Cholla Blvd
Ste B
Tucson, AZ 85741
Phone (520) 547-5845

927 East Blvd
Charlotte, NC 28203
Phone (704) 348-1855

118 Professional Park Dr
Rock Hill, SC 29732
Phone (803) 329-3124

Organizations & group practices 6

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1063521235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17111 NW 69TH AVE",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986429030",
            "telephone_number": "360-989-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17111 NW 69TH AVE",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986429030",
            "telephone_number": "360-989-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALENSHUS",
        "first_name": "ANN",
        "middle_name": "LOEFFLER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "096006546",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "245585",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "19775",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30003999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.