Paula Stork, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C00177 Issued in AR

Practice address

160 Highway 201 N
Mountain Home, AR 72653-3158

Phone

(870) 508-2100

Fax

(870) 508-2150

NPI assigned

Aug 2, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ms. Paula Ennen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

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.

• Arkansas Valley Anesthesia Associates, P. a.

  • Anesthesiology Physician
  • Russellville, AR
  • NPI 1770584393
  NPD (past)
• Outpatient Surgery Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Mountain Home, AR
  • NPI 1730132853
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1144221094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 434",
            "city": "GASSVILLE",
            "state": "AR",
            "postal_code": "726350434",
            "telephone_number": "870-435-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 HIGHWAY 201 N",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533158",
            "telephone_number": "870-508-2100",
            "fax_number": "870-508-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORK",
        "first_name": "PAULA",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C00177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430024522",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AR",
            "identifier": "59498",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119778701",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "ENNEN",
            "prefix": "MS.",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Niger Stice, PA-C
• Amanda D Still
• David A Stills, MD
• Linda Stills, LPE
• Jennifer Rae Stone
• Beth A Storm, LCSW
• Leida Lynda Ivette Stovall, AUD
• Angela Stowe, LPN
• Lacie Racheal Stowe, LCSW
• Megan Stramaglia

• Certified Registered Nurse Anesthetist in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.