St Luke'S Princeton LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

ST LUKE'S PRINCETON LLC

Practice address

1333 Southview Dr
Bluefield, WV 24701-4317

Phone

(304) 327-2900

Fax

(304) 327-2989

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Jerry D Aldridge, CRNA

Title

Crna

Phone

(304) 327-2900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ST LUKE'S PRICETON LLC Former legal business name

Tax ID family

St Luke'S Priceton LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• St. Luke'S Hospital

  • Surgery Physician
  • Bluefield, WV
  • NPI 1710031240
  NPD tax ID

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144303678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 SOUTHVIEW DR",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247014317",
            "telephone_number": "304-327-2900",
            "fax_number": "304-327-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 SOUTHVIEW DR",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247014317",
            "telephone_number": "304-327-2900",
            "fax_number": "304-327-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE'S PRINCETON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALDRIDGE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CRNA",
        "authorized_official_telephone_number": "304-327-2900",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068965000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKE'S PRICETON LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sherry Lynn Smith
• Billy Joe Southern Jr.
• Southside Prof Pharmacy Inc
• Southview Leasing Co., LLC
• Bonnie Crystal Sparks
• St. Luke'S Hospital
• St. Luke'S Princeton LLC
• St. Lukes Princeton LLC
• Amber Stacy
• Nancy Stark

• Certified Registered Nurse Anesthetist in Bluefield, WV
• Providers in Bluefield, WV by specialty
• Certified Registered Nurse Anesthetist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.