Lifeguard Anesthesia Services LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

LIFEGUARD ANESTHESIA SERVICES LLC

Practice address

6310 E 102ND St
Tulsa, OK 74137-7061

Phone

(870) 530-4660

NPI assigned

Sep 11, 2017

Last updated

Apr 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy Gibson, CRNA

Title

Provider

Phone

(816) 914-2583

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1225557242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5406 E 110TH PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377253",
            "telephone_number": "870-530-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 E 102ND ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377061",
            "telephone_number": "870-530-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGUARD ANESTHESIA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-11",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "816-914-2583",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.