Supreme Anesthesia Care Services,LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

173966 Issued in NC

Legal business name

SUPREME ANESTHESIA CARE SERVICES,LLC

Practice address

132 Breckenridge Dr
Garner, NC 27529-7524

Phone

(919) 621-3751

NPI assigned

Oct 22, 2015

Organization subpart

No

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

Authorized official

Name

Varnar Dalise Spencer, MSN,CRNA

Title

Ceo

Phone

(919) 621-3751

Specialties & licenses 1

Addresses

Tax ID family

Supreme Anesthesia Care Servicesllc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Supreme Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • Garner, NC
  • NPI 1225498629
  NPD tax ID

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445472000000",
    "number": "1275905879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 BRECKENRIDGE DR",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275297524",
            "telephone_number": "919-621-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 BRECKENRIDGE DR",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275297524",
            "telephone_number": "919-621-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME ANESTHESIA CARE SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-22",
        "last_updated": "2015-10-22",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "VARNAR",
        "authorized_official_middle_name": "DALISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-621-3751",
        "authorized_official_credential": "MSN,CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "173966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Nichole Stroup-Mishenko, RBT, BCBA, LBA
• Emily Sudweeks, RN, MSN, FNP-BC
• Erin Ebaugh Sukhu, MD
• Stacey Leigh Sullivan, MSW
• Tiffany Nakika Summers, LCSW
• Supreme Anesthesia Services
• Kathryn Sweeney, PTA
• Elizabeth Margaret Swilley
• Sara Colmer Syvinski, ANP
• George A Tabb Jr., LCSWA

• Certified Registered Nurse Anesthetist in Garner, NC
• Providers in Garner, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.