Individual provider Active NPI

Nicole Greenlee

  • Certified Registered Nurse Anesthetist
  • Lebanon, NH
National Provider Identifier
1417466558
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
088871-23 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 650-5000
NPI assigned
Sep 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9405091 FL
Certified Registered Nurse Anesthetist 367500000X 9405091 FL
Certified Registered Nurse Anesthetist 367500000X 77911 ID
Certified Registered Nurse Anesthetist 367500000X 088871-23 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Other practice location 1

1261 S Tamiami Trl
Sarasota, FL 34239-2219
Phone (941) 366-1164

Other practice location 2

1200 7th Ave N
St Petersburg, FL 33705-1300
Phone (727) 210-8104

Other practice location 3

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-6416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NH, DC, VA, ID5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20180301001047 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537420823 Reassigns benefits to 3 organizations
I20221010002329 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537420823 Reassigns benefits to 1 organization
I20230309001557 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537420823 Reassigns benefits to 3 organizations
I20230711001044 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537420823 Reassigns benefits to 1 organization
I20231109002262 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537420823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alphonsus Professional Medical Services LLCGroup PAC ID 7214849751, 124 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2152

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9405091FLMDRegistered Nurse
77911IDMDCertified Registered Nurse Anesthetist
088871-23NHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Cares - Community CurrentSince Jun 12, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Sep 6, 2022 Accepting new patients
Reston Anesthesia Associates, PC CurrentSince Jun 1, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Sep 6, 2022 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Nov 1, 2023 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Jan 1, 2023 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Jan 1, 2023 Accepting new patients
Sarasota Anesthesiologists, PA CurrentSince Jan 24, 2018 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Nov 1, 2023 Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince Mar 20, 2018 Accepting new patients
Amsurg Tampa Bay Anesthesia LLC CurrentSince Jul 20, 2020 Accepting new patients
Greater Florida Anesthesiologists, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 20, 2018 Accepting new patients
Greater Florida Anesthesiologists, LLC Current Accepting new patients
Sarasota Anesthesia Past Accepting new patients

Locations

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

2140 W 68th St
Hialeah, FL 33016
Phone (305) 822-4107

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

1261 S Tamiami Trl
Sarasota, FL 34239
Phone (941) 366-1164

1941 Waldemere St
Sarasota, FL 34239
Phone (941) 366-2360

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

1200 7th Ave N
St Petersburg, FL 33705
Phone (727) 820-7764

4809 N Armenia Ave
Ste 100
Tampa, FL 33603
Phone (813) 872-9310

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1417466558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1261 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342392219",
            "country_code": "US",
            "telephone_number": "941-366-1164",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 7th Ave N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337051300",
            "country_code": "US",
            "telephone_number": "727-210-8104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061309",
            "country_code": "US",
            "telephone_number": "208-367-6416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENLEE",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9405091",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9405091",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "77911",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "088871-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.