Individual provider Active NPI

Ian David Stoddard, CRNA

  • Certified Registered Nurse Anesthetist
  • Yakima, WA
National Provider Identifier
1417470311
Registry record updated Aug 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60781545 Issued in WA
Practice address
110 S 9TH Ave
Yakima, WA 98902-3315
Phone
(509) 575-5000
NPI assigned
Jul 23, 2017
Last updated
Aug 16, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2017

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 AP60781545 WA Primary

Addresses

Primary practice location

110 S 9TH Ave
Yakima, WA 98902-3315

Mailing address

110 S 9TH Ave
Yakima, WA 98902-3315
Phone (509) 574-4455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031000952 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648546036 Reassigns benefits to 4 organizations

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
Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

1703 S Meridian
Suite 305
Puyallup, WA 98371-7590
Phone (253) 841-3933

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60781545WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Hernia and Surgical Solutions PS CurrentSince Feb 1, 2023 Accepting new patients
Washington Gastroenterology PLLC CurrentSince Aug 1, 2021 Accepting new patients
Washington Gastroenterology PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2021 Accepting new patients
Sunnyside Community Hospital Association CurrentSince Sep 1, 2017 Accepting new patients
Washington Gastroenterology PLLC CurrentSince Aug 1, 2021 Accepting new patients
Cascade Hernia and Surgical Solutions PS CurrentSince Feb 1, 2023 Accepting new patients
Anesthesia Associates Northwest LLC CurrentSince Feb 1, 2021 Accepting new patients
Sunnyside Community Hospital Association Current Accepting new patients
Sunnyside Community Hospital Assocation CurrentSince Sep 1, 2017 Accepting new patients

Locations

34503 9th Ave S
Ste 240
Federal Way, WA 98003
Phone (253) 838-9839

2727 Hollycroft St
Ste 480
Gig Harbor, WA 98335
Phone (253) 858-0112

17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660

11216 Sunrise Blvd E
Ste 3-201
Puyallup, WA 98374
Phone (253) 770-3700

11216 Sunrise Blvd E
Ste 3207
Puyallup, WA 98374
Phone (253) 272-8148

1703 S Meridian
Ste 203
Puyallup, WA 98371
Phone (253) 841-3933

1703 S Meridian
Ste 305
Puyallup, WA 98371
Phone (253) 841-3933

208 17th Ave SE
#201
Puyallup, WA 98372
Phone (253) 840-1999

2925 Allen Rd
Sunnyside, WA 98944
Phone (509) 837-4949

803 E Lincoln Ave
Sunnyside, WA 98944
Phone (509) 837-3933

3209 S 23rd St
Ste 200
Tacoma, WA 98405
Phone (253) 503-2508

8506 E Mill Plain Blvd
Ste C
Vancouver, WA 98664
Phone (360) 823-0880

110 S 9th Ave
Yakima, WA 98902
Phone (509) 575-5000

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1417470311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S 9TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023315",
            "telephone_number": "509-574-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S 9TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023315",
            "telephone_number": "509-575-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "IAN",
        "middle_name": "DAVID",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-23",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60781545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; 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.