Kimberly A.H. Sundland, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R813576 Issued in MS

Practice address

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Phone

(601) 261-3606

Fax

(601) 579-5383

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment NPD
• Lifelinc Anesthesia, PLLC

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1801021464

  MS, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Gastrointestinal Associates, P.a.

  • Gastroenterology Physician
  • Vicksburg, MS
  • NPI 1144412438
  NPD (past)
• QHG of Hattiesburg Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Hattiesburg, MS
  • NPI 1326032400
  NPD (past)
• North American Partners in Anesthesia (Virginia), LLC

  • Anesthesiology Physician
  • Fairfax, VA
  • NPI 1922031442
  NPD (past)
• Outpatient Anesthesia Services of Reston, LTD

  • Anesthesiology Physician
  • Reston, VA
  • NPI 1376654434
  NPD (past)
• Southeastern Wisconsin Anesthesiology, S.C.

  • Anesthesiology Physician
  • Burlington, WI
  • NPI 1639125701
  NPD (past)
• Under Anesthesia

  • Anesthesiology Physician
  • Sumter, SC
  • NPI 1194018242
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1083707814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023107",
            "telephone_number": "601-264-3937",
            "fax_number": "601-264-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-3606",
            "fax_number": "601-579-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDLAND",
        "first_name": "KIMBERLY",
        "middle_name": "A.H.",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "3870",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R813576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02576323",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8824103",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST 2005",
            "identifier": "K142-0002",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON",
            "identifier": "139180",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "484645",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083707814",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3461546",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9840251",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "302I439809",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loretta Sullivan, IDD WAIVER SERVICES
• William Bruns Sullivan
• Sunbelt Rehabilitation Systems, LLC (Sunbelt Rehab)
• Ellen M Sundberg, PH.D.
• Aimee Sundeen, M.D.
• Sunrise Healthcare LLC
• Super D Drugs Acquisition Co (Super D Express RX)
• Super Docs Inc (Super D Express RX)
• Amy Gardner Sutton, D.M.D.
• Rebecca E Swan, NP-C

• Certified Registered Nurse Anesthetist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; 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.