Individual provider Active NPI

Reed Ward Burbank, CRNA

  • Certified Registered Nurse Anesthetist
  • Olympia, WA
National Provider Identifier
1093928236
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60863426 Issued in WA
Practice address
209 Lilly Rd NE
Olympia, WA 98506
Phone
(360) 413-8250
Fax
(360) 413-8830
NPI assigned
May 7, 2007
Last updated
Apr 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00033804 WA
Certified Registered Nurse Anesthetist 367500000X AP60863426 WA Primary

Addresses

Primary practice location

209 Lilly Rd NE
Olympia, WA 98506

Mailing address

209 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8250

Other practice location 1

500 Lilly Rd NE Ste 150
Olympia, WA 98506-9106
Phone (360) 413-8250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181002002296 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618229626 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CH00033804WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Richland a Division of Premier Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2018 Accepting new patients
Gastroenterology Associates Clinical Practice, PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2019 Accepting new patients
Everett Accident and Injury Center PS Corp Chiropractor Past Accepting new patients

Locations

209 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8250

500 Lilly Rd NE
Ste 204
Olympia, WA 98506
Phone (360) 413-8191

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

Organizations & group practices 3

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1093928236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-413-8250",
            "fax_number": "360-413-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-413-8250",
            "fax_number": "360-413-8830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Lilly Rd NE Ste 150",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985069106",
            "country_code": "US",
            "telephone_number": "360-413-8250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURBANK",
        "first_name": "REED",
        "middle_name": "WARD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033804",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60863426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.