Caressa Rae Southers, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

077833 Issued in WV

Practice address

109 Morrison Dr
Princeton, WV 24740-2322

Phone

(304) 487-3559

Fax

(304) 487-7928

NPI assigned

Mar 13, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospitalist Medicine Physicians of West Virginia - South CharlestonGroup PAC ID 7911437603, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Hospitalist Medicine Physicians of West Virginia - South Charleston

  • Anesthesiology Physician
  • Princeton, WV
  • NPI 1063228120
  Medicare reassignment Care Compare group NPD
• East River Anesthesiology Inc

  • Anesthesiology Physician
  • Princeton, WV
  • NPI 1740711795
  Medicare reassignment NPD

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

• Princeton Community Hospital Assn., Inc.

  • General Acute Care Hospital
  • Princeton, WV
  • NPI 1558313213
  Care Compare affiliation

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1205252327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1143",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247401143",
            "telephone_number": "304-487-3559",
            "fax_number": "304-487-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 MORRISON DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402322",
            "telephone_number": "304-487-3559",
            "fax_number": "304-487-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERS",
        "first_name": "CARESSA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-13",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "077833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Highlands Community Mental Health Center, Inc.
• Southern Highlands Community Mental Health Center, Inc.
• Southern Highlands Community Mental Health Center, Inc.
• Southern Highlands Community Mental Health Center, Inc.
• Adrianna Lynn Southern
• Donna G Southers, PA-C
• Gregory G. Southers, PA-C
• Amy Sparks
• Angela Sparks, FNP-BC
• William Sparks

• Certified Registered Nurse Anesthetist in Princeton, WV
• Providers in Princeton, 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 Jan 5, 2015; 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.