NPIMap

Organization Active NPI

Nodak Anesthesia, Inc

  • Anesthesiology Physician
  • Hanford, CA
National Provider Identifier
1386836997
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
GRN000140 Issued in CA
Legal business name
NODAK ANESTHESIA, INC
Practice address
1025 N Douty St
Central Valley Gen. Hospital
Hanford, CA 93230-3722
Phone
(559) 587-4344
NPI assigned
Aug 16, 2007
Last updated
Aug 16, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Authorized official

Name
J. Wynn Allen, CRNA
Title
President
Phone
(559) 816-5062

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X GRN000140 CA Primary

Addresses

Primary practice location

1025 N Douty St
Central Valley Gen. Hospital
Hanford, CA 93230-3722

Mailing address

PO Box 264
Lemoore, CA 93245-0264
Phone (559) 813-5062

Other identifiers 1

IdentifierTypeStateIssuer
GRN000140MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1386836997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 264",
            "city": "LEMOORE",
            "state": "CA",
            "postal_code": "932450264",
            "telephone_number": "559-813-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N DOUTY ST",
            "address_2": "CENTRAL VALLEY GEN. HOSPITAL",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932303722",
            "telephone_number": "559-587-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NODAK ANESTHESIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "WYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-816-5062",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "GRN000140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GRN000140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanford, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.