Organization Active NPI

Traveling Crna LLC

  • Anesthesiology Physician
  • Rosedale, MD
National Provider Identifier
1366112906
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
TRAVELING CRNA LLC
Practice address
5233 King Ave Ste 208
Rosedale, MD 21237-4003
Phone
(443) 889-8558
NPI assigned
Sep 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Authorized official

Name
Anne Muntuerto
Title
Crna/Owner
Phone
(443) 889-8558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

5233 King Ave Ste 208
Rosedale, MD 21237-4003

Mailing address

6210 Briar CT
Elkridge, MD 21075-5941
Phone (443) 889-8558

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211012002987 MD Part B Supplier - Clinic/Group Practice 8123426715 Receives reassigned benefits from 1 practitioner
Practice locations: Rosedale, MD

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": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1366112906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 BRIAR CT",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755941",
            "telephone_number": "443-889-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5233 KING AVE STE 208",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374003",
            "telephone_number": "443-889-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVELING CRNA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "MUNTUERTO",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "CRNA/OWNER",
        "authorized_official_telephone_number": "443-889-8558"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.