Individual provider Active NPI

Danny Coleman Sandefur, CRNA

  • Certified Registered Nurse Anesthetist
  • Langley AFB, VA
National Provider Identifier
1083892780
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024171324 Issued in VA
Practice address
77 Nealy Ave
Langley AFB, VA 23665-2040
Phone
(702) 236-2862
NPI assigned
Feb 5, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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 0024171324 VA Primary

Addresses

Primary practice location

77 Nealy Ave
Langley AFB, VA 23665-2040

Mailing address

6 Quail CV
Poquoson, VA 23662-1742
Phone (702) 236-2862

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140821002800 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537349857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Uniformed Services Uhs Fe Hebert School of Med, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMG Anesthesia Specialists LLCGroup PAC ID 6305081118, 501 clinicians

Practice addresses (Care Compare)

11803 Jefferson Ave
Newport News, VA 23606-2565
Phone (757) 736-9898

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024171324VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Anesthesia Group, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 14, 2019 Accepting new patients
SMG Anesthesia Specialists LLC CurrentSince Jun 16, 2014 Accepting new patients
Alaska Spine Center, LLC Past Accepting new patients
Chugach Anesthesia, LLC PastSince Dec 17, 2012 Accepting new patients

Locations

595 Martha Jefferson Dr
Ste 290
Charlottesville, VA 22911
Phone (434) 293-4995

11803 Jefferson Ave
Newport News, VA 23606
Phone (757) 594-1000

1501 Maple Ave
Ste 300
Richmond, VA 23226
Phone (804) 287-7878

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

828 Healthy Way
Ste 115
Virginia Beach, VA 23462
Phone (757) 388-6200

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1083892780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 QUAIL CV",
            "city": "POQUOSON",
            "state": "VA",
            "postal_code": "236621742",
            "telephone_number": "702-236-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NEALY AVE",
            "city": "LANGLEY AFB",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "702-236-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDEFUR",
        "first_name": "DANNY",
        "middle_name": "COLEMAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-05",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024171324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Langley AFB, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.