NPIMap

Organization Active NPI

Grandview Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Dubuque, IA
National Provider Identifier
1407458367
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
GRANDVIEW ANESTHESIA PC
Practice address
350 N Grandview Ave
Dubuque, IA 52001-6388
Phone
(507) 459-2358
NPI assigned
Nov 14, 2020
Last updated
Dec 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Authorized official

Name
Phillip Guillien, CRNANPI 1265999809
Title
Owner
Phone
(507) 459-2358

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

350 N Grandview Ave
Dubuque, IA 52001-6388

Mailing address

PO Box 49
Pittsburgh, PA 15230-0049
Phone (877) 746-7090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201203001612 IA Part B Supplier - Clinic/Group Practice 0749691335 Receives reassigned benefits from 19 practitioners
Practice locations: Dubuque, IA
O20250509002529 WI Part B Supplier - Clinic/Group Practice 0749691335 Receives reassigned benefits from 8 practitioners
Practice locations: Hazel Green, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1605312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1407458367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152300049",
            "telephone_number": "877-746-7090",
            "fax_number": "412-937-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N GRANDVIEW AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016388",
            "telephone_number": "507-459-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDVIEW ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-14",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "GUILLIEN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-459-2358",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.