Individual provider Active NPI

Suzette Henahan, CRNA

  • Certified Registered Nurse Anesthetist
  • Newport News, VA
National Provider Identifier
1225092232
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0001130309 Issued in VA
Practice address
11848 Rock Landing Dr
Newport News, VA 23606-4425
Phone
(757) 591-2260
NPI assigned
Apr 14, 2006
Last updated
Feb 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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 0001130309 VA Primary

Addresses

Primary practice location

11848 Rock Landing Dr
Newport News, VA 23606-4425

Mailing address

150 Bluff Ave
North Augusta, SC 29841-3862
Phone (800) 394-4445

Other names 1

  • Suzette Knudtson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041119000714 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698730513 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Digestive Care LLCGroup PAC ID 3870669419, 241 clinicians

Practice addresses (Care Compare)

113 Gainsborough SQ
Suite 101
Chesapeake, VA 23320-1713
Phone (757) 436-3285

1717 Will O Wisp Dr
Suite 200
Virginia Beach, VA 23454-3102
Phone (757) 481-4817

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001130309VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Capital Digestive Care LLC CurrentSince Aug 1, 2022 Accepting new patients
Capital Digestive Care, LLC CurrentSince Aug 1, 2022 Accepting new patients
Goodwin & Snyder Anesthesia Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2019 Accepting new patients
Bayview Physician Services, PC CurrentSince May 1, 2021 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2020 Accepting new patients
Bayview Physician Services, PC CurrentSince May 1, 2021 Accepting new patients
Capital Digestive Care ,LLC Current Accepting new patients
James River Comprehensive Pain Management Past Accepting new patients
James River Anesthesia Assoc., Inc Past Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

113 Gainsborough Sq
Ste 101
Chesapeake, VA 23320
Phone (757) 436-3285

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

241 Corporate Blvd
Norfolk, VA 23502
Phone (757) 362-3577

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

2000 Meade Pkwy
Suffolk, VA 23434
Phone (757) 539-0251

1717 Will O Wisp Dr
Ste 200
Virginia Beach, VA 23454
Phone (757) 481-4817

1925 Glenn Mitchell Dr
Ste 102
Virginia Beach, VA 23456
Phone (757) 464-1644

465 N Great Neck Rd
Virginia Beach, VA 23454
Phone (757) 481-5555

828 Healthy Way
Ste 210
Virginia Beach, VA 23462
Phone (757) 481-4817

5215 Monticello Ave
Williamsburg, VA 23188
Phone (757) 229-4000

Interoperability endpoints

  • FHIR API: https://b9dda605-4d4e-4319-b477-73b223ba7709.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1225092232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BLUFF AVE",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298413862",
            "telephone_number": "800-394-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11848 ROCK LANDING DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064425",
            "telephone_number": "757-591-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENAHAN",
        "first_name": "SUZETTE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001130309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZETTE",
            "last_name": "KNUDTSON",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.