Independence Anesthesia LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

INDEPENDENCE ANESTHESIA LLC

Practice address

1710 Mayfield Dr
Jonesboro, AR 72401-4563

Phone

(870) 613-8390

NPI assigned

Oct 2, 2020

Organization subpart

No

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

Authorized official

Name

Steven Stalker, NPNPI 1902846587

Title

Owner

Phone

(870) 613-8390

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 4

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

• Steven Stalker, CRNA

  • Certified Registered Nurse Anesthetist
  • Batesville, AR
  • NPI 1902846587
  Medicare reassignment Care Compare group NPD Authorized official
• Mark Warren McFatridge, CRNA

  • Certified Registered Nurse Anesthetist
  • Searcy, AR
  • NPI 1205801073
  Medicare reassignment Care Compare group NPD
• Marvin Kullen Poe, CRNA

  • Certified Registered Nurse Anesthetist
  • West Plains, MO
  • NPI 1669815122

  AR

  Medicare reassignment Care Compare group NPD
• Lindy Sanders Page, CRNA

  • Certified Registered Nurse Anesthetist
  • Benton, AR
  • NPI 1154818292
  Medicare reassignment NPD

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1114524147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3283",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725033283",
            "telephone_number": "870-613-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 MAYFIELD DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014563",
            "telephone_number": "870-613-8390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 S Main St",
            "address_purpose": "LOCATION",
            "city": "Searcy",
            "state": "AR",
            "postal_code": "721437318",
            "country_code": "US",
            "telephone_number": "870-613-8390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INDEPENDENCE ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "STALKER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-613-8390",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CO1386",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.