Individual provider Active NPI

Tamara S Minnix, CRNA

  • Certified Registered Nurse Anesthetist
  • Huntington, WV
National Provider Identifier
1104907773
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
41769 Issued in WV
Practice address
1340 Hal Greer Blvd
Huntington, WV 25701-3800
Phone
(888) 245-5525
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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 41769 WV Primary

Addresses

Primary practice location

1340 Hal Greer Blvd
Huntington, WV 25701-3800

Mailing address

PO Box 714960
Columbus, OH 43271-4960
Phone (888) 245-5525

Other identifiers 5

IdentifierTypeStateIssuer
0068794000MedicaidWV
74430216MedicaidKY
0892851MedicaidOH
001720975OtherWVBCBS
1067623OtherWVWORKERS' COMP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050524001241 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294777835 Reassigns benefits to 3 organizations
I20240405001716 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294777835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oasis Anesthesia LLCGroup PAC ID 5597063834, 7 clinicians

Practice addresses (Care Compare)

2335 Chesterfield Ave
Suite 400
Charleston, WV 25304-1066
Phone (304) 417-1255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41769WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of West Virginia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 12, 2016 Accepting new patients
Cabell Huntington Hospital Inc CurrentSince Nov 18, 2009 Accepting new patients
Cabell Huntington Hospital Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 18, 2009 Accepting new patients
Oasis Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2018 Accepting new patients
Charleston Surgical Hospital Healthcare Group, PLLC Past Accepting new patients
Day Surgery Limited Liability Past Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

405 S 3rd St
Ironton, OH 45638
Phone (304) 417-1255

2335 Chesterfield Ave
Ste 400
Charleston, WV 25304
Phone (304) 417-1255

1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960

1201 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 523-1885

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1104907773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 714960",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432714960",
            "telephone_number": "888-245-5525",
            "fax_number": "717-653-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013800",
            "telephone_number": "888-245-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIX",
        "first_name": "TAMARA",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "41769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068794000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74430216",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0892851",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001720975",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS' COMP",
            "identifier": "1067623",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; 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.