Capital City Anesthesia LLC
Organization Active NPI Anesthesiology Physician · Tallahassee, FL
NPI 1346212669 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1346212669
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- CAPITAL CITY ANESTHESIA LLC
- Practice address
- 2010 Fleischmann Rd
Tallahassee, FL 32308-4599 - Phone
- (850) 552-0608
- Fax
- (850) 552-0925
- NPI assigned
- Feb 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Patrice Talley Bidwell, MD
- Title
- Owner/President
- Phone
- (850) 656-4277
Practitioners 15
-
Aisha Ganzy Allen, CRNA
-
Jeanna L. Davenport, CRNA
-
Ashley Wald Lafferty, CRNA
-
Lauren N Phillips, CRNA
-
Lisa L. Umana, CRNA
-
Charles Lamar Clayton, CRNA
-
Susan Lee Daffin, CRNA
-
Douglas James Deszell, CRNA
-
George Michael Kelbert, CRNA
-
Patti Dirkse Pijut, CRNA
-
Devon Sean Barger, CRNA
-
Jeremy Brian Cushing, CRNA
-
William H Hass, MD
-
John Frederick Kycey, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060125000930 | FL | Part B Supplier - Clinic/Group Practice | 0941214258 |
Receives reassigned benefits from 7 practitioners Practice locations: Tallahassee, FL |
National Provider Directory
Locations
2910 Kerry Forest Pkwy
Ste D4
Tallahassee, FL 32309
Phone (229) 228-5801
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | FL | Yes | |
| Pain Medicine (Anesthesiology) Physician |
207LP2900X | FL | ||
| Certified Registered Nurse Anesthetist |
367500000X | FL |
Addresses
Primary practice location
2010 Fleischmann Rd
Tallahassee, FL 32308-4599
Mailing address
P.O. Box 919030
Orlando, FL 32891-9030
Phone (850) 656-4277
Other providers in Tallahassee, FL
- Staci Cantrell
- Amanda Elizabeth Capece
- Adrienne Capeless
- Capital Anesthesia PLLC
- Capital Chiropractic & Rehab LLC
- Capital City Music Therapy, LLC
- Capital City Oasis Home Care LLC
- Capital City Oasis Home Care LLC
- Capital City Surgery Center of Florida LLC
- Capital City Surgical Center LLC
All providers in Tallahassee, FL · Anesthesiology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.