NPIMap

Organization Active NPI

Summit Anesthesia LLC

  • Anesthesiology Physician
  • Eagan, MN
National Provider Identifier
1104358464
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SUMMIT ANESTHESIA LLC
Practice address
2620 Eagan Woods Drive
Suite 300
Eagan, MN 55121-1466
Phone
(651) 730-3532
NPI assigned
Mar 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Authorized official

Name
Adam Berry
Title
Chief Executive Officer
Phone
(651) 968-5333

Specialties & licenses 2

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

Addresses

Primary practice location

2620 Eagan Woods Drive
Suite 300
Eagan, MN 55121-1466

Mailing address

710 Commerce Dr
Suite 200
Woodbury, MN 55125-4919

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1104358464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR",
            "address_2": "SUITE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 EAGAN WOODS DRIVE",
            "address_2": "SUITE 300",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211466",
            "telephone_number": "651-730-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "651-968-5333"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.