Individual provider Active NPI

Ryan Willis Lindemann

  • Certified Registered Nurse Anesthetist
  • Middletown, CT
National Provider Identifier
1164775995
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
5223 Issued in CT
Practice address
207 George St Apt 534
Middletown, CT 06457-6703
Phone
(940) 867-0959
NPI assigned
Oct 17, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 092460 CT
Registered Nurse 163W00000X 732793 TX
Certified Registered Nurse Anesthetist 367500000X 5223 CT Primary

Addresses

Primary practice location

207 George St Apt 534
Middletown, CT 06457-6703

Mailing address

207 George St Apt 534
Middletown, CT 06457-6703
Phone (940) 867-0959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170920001937 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305090556 Reassigns benefits to 3 organizations
I20240904003561 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305090556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
West Idaho Anesthesia, LLPGroup PAC ID 9133343031, 15 clinicians

Practice addresses (Care Compare)

251 SW 19TH St
Ontario, OR 97914-1972
Phone (541) 889-3198

3115 Medical Dr
Caldwell, ID 83605-6972
Phone (208) 453-8668

Hospital & facility affiliations

  • West Valley Medical Center Hospital, Caldwell, ID, CCN 130014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
5223CTMDProfessional Counselor
092460CTMDRegistered Nurse
732793TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Boise, P.a. CurrentSince Jul 9, 2020 Accepting new patients
Cardiac and Arrhythmia Center of Idaho PLLC CurrentSince Jun 1, 2022 Accepting new patients
West Idaho Anesthesia, LLP Nurse Anesthetist, Certified Registered CurrentSince Aug 6, 2020 Accepting new patients
Boise Anesthesia, P a Nurse Anesthetist, Certified Registered CurrentSince Sep 11, 2017 Accepting new patients
Everest ASC Past Accepting new patients
Woodland Anesthesia Associates PC Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

2537 W State St
Ste 200
Boise, ID 83702
Phone (208) 336-0895

338 E Bannock St
Boise, ID 83712
Phone (208) 336-0895

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3115 Medical Dr
Caldwell, ID 83605
Phone (208) 453-8668

1000 State St
McCall, ID 83638
Phone (208) 634-2221

2960 E St Lukes St
Ste 100
Meridian, ID 83642
Phone (208) 378-4264

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

251 SW 19th St
Ontario, OR 97914
Phone (541) 889-3106

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1164775995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 GEORGE ST APT 534",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064576703",
            "telephone_number": "940-867-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 GEORGE ST APT 534",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064576703",
            "telephone_number": "940-867-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDEMANN",
        "first_name": "RYAN",
        "middle_name": "WILLIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "092460",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "732793",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "5223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.