NPIMap

Organization Active NPI

Blue Ridge Anesthesia Associates LLC

  • Anesthesiology Physician
  • Hagerstown, MD
National Provider Identifier
1407964646
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
BLUE RIDGE ANESTHESIA ASSOCIATES LLC
Practice address
11116 Medical Campus Road
Hagerstown, MD 21742-6710
Phone
(301) 665-1717
Fax
(301) 665-1810
NPI assigned
Aug 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Authorized official

Name
Dr. Carlo John Cutler, D.O.
Title
Department Head
Phone
(301) 665-1717

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X MD Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X MD
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X MD

Addresses

Primary practice location

11116 Medical Campus Road
Hagerstown, MD 21742-6710

Mailing address

PO Box 1248
Hagerstown, MD 21741-1248
Phone (301) 665-1717

Other identifiers 2

IdentifierTypeStateIssuer
452002500MedicaidMD
0015906630005MedicaidPA

Other names 1

  • Blue Ridge Anesthesia, LLC Other name

National Provider Directory

National Provider Directory

Locations

119 King St
Hagerstown, MD 21740
Phone (301) 665-1717

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304294400000",
    "number": "1407964646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1248",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217411248",
            "telephone_number": "301-665-1717",
            "fax_number": "301-665-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS ROAD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "301-665-1717",
            "fax_number": "301-665-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE ANESTHESIA ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2011-05-02",
        "status": "A",
        "authorized_official_last_name": "CUTLER",
        "authorized_official_first_name": "CARLO",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DEPARTMENT HEAD",
        "authorized_official_telephone_number": "301-665-1717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "452002500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015906630005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Ridge Anesthesia, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.