Organization Active NPI

Csra Anesthesia

  • Certified Registered Nurse Anesthetist
  • Evans, GA
National Provider Identifier
1346569142
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN108812 Issued in GA
Legal business name
CSRA ANESTHESIA
Practice address
4480 Sparkleberry CT
Evans, GA 30809-4454
Phone
(706) 868-0131
Fax
(706) 210-0771
NPI assigned
May 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Authorized official

Name
Mr. Dean Roger Loss, CRNA
Title
President
Phone
(706) 868-1410

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X RN108812 GA Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X 1388 SC

Addresses

Primary practice location

4480 Sparkleberry CT
Evans, GA 30809-4454

Mailing address

P O Box 21151
Martinez, GA 30917-1551
Phone (706) 868-0131

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1346569142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 21151",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309171551",
            "telephone_number": "706-868-0131",
            "fax_number": "706-854-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 SPARKLEBERRY CT",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094454",
            "telephone_number": "706-868-0131",
            "fax_number": "706-210-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSRA ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-19",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "LOSS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-868-1410",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN108812",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "1388",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.