Individual provider Active NPI

Christine Perdzock, CRNA

  • Certified Registered Nurse Anesthetist
  • Naples, FL
National Provider Identifier
1366401168
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1513504 Issued in FL
Practice address
6101 Pine Ridge Rd
Naples, FL 34119-3900
Phone
(239) 304-4862
Fax
(239) 304-5157
NPI assigned
Mar 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1513504 FL Primary
Registered Nurse 163W00000X 9228368 FL

Addresses

Primary practice location

6101 Pine Ridge Rd
Naples, FL 34119-3900

Mailing address

6101 Pine Ridge Rd
Naples, FL 34119-3900
Phone (239) 304-4862

Other identifiers 1

IdentifierTypeStateIssuer
308111700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070807000655 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850344995 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9228368FLMDRegistered Nurse
1513504FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Coral Anesthesia Associates, Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 4, 2016 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 4, 2016 Accepting new patients
Coral Anesthesia Associates, Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 4, 2016 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Jan 4, 2016 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Doctors Anesthesia Services of Columbus Inc Past Accepting new patients
Ophthalmic Anesthesia Associates Inc PastSince Jul 24, 2022 Accepting new patients

Locations

1879 Veterans Park Dr
Ste 1101
Naples, FL 34109
Phone (239) 248-7623

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

5731 Bee Ridge Rd
Sarasota, FL 34233
Phone (888) 221-2216

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1366401168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 PINE RIDGE RD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341193900",
            "telephone_number": "239-304-4862",
            "fax_number": "239-304-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 PINE RIDGE RD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341193900",
            "telephone_number": "239-304-4862",
            "fax_number": "239-304-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDZOCK",
        "first_name": "CHRISTINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "1513504",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9228368",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308111700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.