Individual provider Active NPI

Johnny Bairos, CRNA

  • Certified Registered Nurse Anesthetist
  • Colton, CA
National Provider Identifier
1366776205
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3807 Issued in CA
Practice address
900 E Washington Street #155
Colton, CA 92324-4196
Phone
(951) 312-8034
NPI assigned
Sep 24, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3807 CA Primary

Addresses

Primary practice location

900 E Washington Street #155
Colton, CA 92324-4196

Mailing address

429 Marilyn Lane
Redlands, CA 92373-7327
Phone (951) 312-8034

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100217000145 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264576032 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59, LLC CurrentSince Apr 15, 2018 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Lgibson Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2017 Accepting new patients
KND Development 59 LLC CurrentSince Apr 15, 2018 Accepting new patients
Bairos Nursing Anesthesia,Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 7, 2012 Accepting new patients
Desert Cities Anesthesia Professionals Nurse Anesthetist, Certified Registered CurrentSince Jun 15, 2016 Accepting new patients

Locations

900 E Washington St
Ste 155
Colton, CA 92324
Phone (909) 370-2190

5 Holland
Ste 101
Irvine, CA 92618
Phone (949) 588-2199

1180 N Indian Canyon Dr
Ste W110
Palm Springs, CA 92262
Phone (760) 416-4600

35800 Bob Hope Dr
Ste 100
Rancho Mirage, CA 92270
Phone (760) 699-5000

9674 Archibald Ave
Ste 125
Rch Cucamonga, CA 91730
Phone (909) 296-8930

10841 White Oak Ave
Rch Cucamonga, CA 91730
Phone (626) 914-1514

Organizations & group practices 6

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": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1366776205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 MARILYN LANE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737327",
            "telephone_number": "951-312-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E WASHINGTON STREET #155",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244196",
            "telephone_number": "951-312-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIROS",
        "first_name": "JOHNNY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-24",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "3807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.