NPIMap

Organization Active NPI

Dominion Anesthesia, PLLC

  • Anesthesiology Physician
  • Arlington, VA
National Provider Identifier
1073554952
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
DOMINION ANESTHESIA, PLLC
Practice address
1701 N George Mason Dr # Dr.2D
Arlington, VA 22205-3610
Phone
(888) 276-1910
Fax
(517) 787-1027
NPI assigned
Jun 9, 2006
Last updated
Jul 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Authorized official

Name
Trevor Myers, MDNPI 1821020876
Title
Authorized Official
Phone
(888) 276-1910

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X VA Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X VA

Addresses

Primary practice location

1701 N George Mason Dr # Dr.2D
Arlington, VA 22205-3610

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (888) 276-1910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000503 DC Part B Supplier - Clinic/Group Practice 7618863713 Receives reassigned benefits from 157 practitioners
Practice locations: Arlington, VA; MC Lean, VA

National Provider Directory

National Provider Directory

Locations

1701 N George Mason Dr
#2D
Arlington, VA 22205
Phone (703) 558-2438

1701 N George Mason Dr
Ste 2D
Arlington, VA 22205
Phone (703) 558-2438

Practitioners & affiliated clinicians

Practitioners 166

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.

View all 166

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1073554952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "888-276-1910",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N GEORGE MASON DR # DR.2D",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053610",
            "telephone_number": "888-276-1910",
            "fax_number": "517-787-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION ANESTHESIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "888-276-1910",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.