Individual provider Active NPI

Irene A St Paul, CRNA

  • Certified Registered Nurse Anesthetist
  • Bowie, MD
National Provider Identifier
1124218110
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3808 Issued in CT
Practice address
4814 Willes Vision Dr
Bowie, MD 20720-4671
Phone
(973) 666-1404
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0001405 DE
Certified Registered Nurse Anesthetist 367500000X 3808 CT Primary

Addresses

Primary practice location

4814 Willes Vision Dr
Bowie, MD 20720-4671

Mailing address

4814 Willes Vision Dr
Bowie, MD 20720-4671
Phone (973) 666-1404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001405DEMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Norwich Anesthesia Associates, PC Past Accepting new patients

Organizations & group practices 1

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1124218110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4814 WILLES VISION DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204671",
            "telephone_number": "973-666-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4814 WILLES VISION DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204671",
            "telephone_number": "973-666-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST PAUL",
        "first_name": "IRENE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "DE",
            "license": "0001405",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "3808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.