Marshall Anesthesiology, LLC

Key facts

NPI

1124071329

Entity type

Organization (NPI type 2)

Primary specialty

Certified Registered Nurse Anesthetist 367500000X

Legal business name

MARSHALL ANESTHESIOLOGY, LLC

Practice address

2305 S Highway 65
Marshall, MO 65340-3702

Phone

(660) 886-9889

NPI assigned

May 18, 2006

Organization subpart

No

Authorized official

Name

David Lees, CRNA

Title

Partner

Phone

(660) 831-3213

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 29, 2008.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1124071329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 10TH ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 S HIGHWAY 65",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653403702",
            "telephone_number": "660-886-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL ANESTHESIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "LEES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "660-831-3213",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF KANSAS CITY",
            "identifier": "18935029",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "503928004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Marshall, MO · Certified Registered Nurse Anesthetist in Missouri