Proactive Anesthesia Management LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

PROACTIVE ANESTHESIA MANAGEMENT LLC

Practice address

320 1St St N
Suite 603
Jacksonville Beach, FL 32250-6944

Phone

(904) 274-3310

NPI assigned

Dec 10, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Ian Davies

Title

Ceo

Phone

(904) 274-3310

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371772800000",
    "number": "1194060624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 1ST ST N",
            "address_2": "SUITE 603",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506944",
            "telephone_number": "904-274-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 1ST ST N",
            "address_2": "SUITE 603",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506944",
            "telephone_number": "904-274-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE ANESTHESIA MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-10",
        "last_updated": "2013-06-21",
        "status": "A",
        "authorized_official_last_name": "DAVIES",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-274-3310",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; 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.