Individual provider Active NPI

Dana Jo Marshall, CRNA

  • Certified Registered Nurse Anesthetist
  • Augusta, ME
National Provider Identifier
1225077878
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
034249 Issued in ME
Practice address
35 Medical Center Pkwy
Ste 201
Augusta, ME 04330-8160
Phone
(207) 622-1959
Fax
(207) 430-4007
NPI assigned
Jun 6, 2006
Last updated
Apr 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 034249 ME Primary

Addresses

Primary practice location

35 Medical Center Pkwy
Ste 201
Augusta, ME 04330-8160

Mailing address

35 Medical Center Pkwy
Augusta, ME 04330-8160
Phone (207) 622-1959

Other identifiers 1

IdentifierTypeStateIssuer
323370099MedicaidME

Other names 1

  • Dana Jo Larson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, SC, IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050128000362 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183674906 Reassigns benefits to 1 organization
I20241010001897 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183674906 Reassigns benefits to 1 organization
I20260331000647 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183674906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennebec Anesthesia Associates PAGroup PAC ID 8325027428, 36 clinicians

Practice addresses (Care Compare)

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

149 N St
Waterville, ME 04901-4974
Phone (207) 622-1959

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034249MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 23, 2024 Accepting new patients
Kennebec Anesthesia Associates, P.a. CurrentSince Aug 17, 2009 Accepting new patients
Waterville Anesthesia Associates, P.a. Past Accepting new patients

Locations

35 Medical Center Pkwy
#201
Augusta, ME 04330
Phone (207) 622-1959

35 Medical Center Pkwy
Ste 201
Augusta, ME 04330
Phone (207) 620-1136

149 North St
Waterville, ME 04901
Phone (207) 622-1959

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

3545 Highway 17
Ste 100
Murrells Inlet, SC 29576
Phone (843) 299-1717

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1225077878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MEDICAL CENTER PKWY",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308160",
            "telephone_number": "207-622-1959",
            "fax_number": "207-430-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MEDICAL CENTER PKWY",
            "address_2": "STE 201",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308160",
            "telephone_number": "207-622-1959",
            "fax_number": "207-430-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "DANA",
        "middle_name": "JO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "034249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "323370099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "LARSON",
            "middle_name": "JO",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.