Individual provider Active NPI

Dionne Michelle Tyree, CRNA

  • Certified Registered Nurse Anesthetist
  • Petersburg, VA
National Provider Identifier
1427389709
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024168660 Issued in VA
Practice address
200 Medical Park Blvd
Petersburg, VA 23805
Phone
(804) 765-5000
NPI assigned
Jan 26, 2010
Last updated
Apr 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024168660 VA Primary
Registered Nurse 163W00000X 0001138871 VA

Addresses

Primary practice location

200 Medical Park Blvd
Petersburg, VA 23805

Mailing address

3998 Fair Ridge Dr
Suite 300
Fairfax, VI 22033-2921
Phone (703) 295-9360

Other identifiers 1

IdentifierTypeStateIssuer
1427389709MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100427000546 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840327698 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001138871VAMDRegistered Nurse
0024168660VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia, PC CurrentSince Aug 15, 2016 Accepting new patients
Greensboro Anesthesia Specialists Inc Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2019 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Aug 15, 2016 Accepting new patients
Richmond Gastroenterology Associates, Inc. CurrentSince May 1, 2025 Accepting new patients
Sicuro Services Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

1714 E Hundred Rd
Ste 104
Chester, VA 23836
Phone (804) 681-0556

501 Rison St
Ste 130
Danville, VA 24541
Phone (434) 429-4290

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

8262 Atlee Rd
Mechanicsville, VA 23116
Phone (804) 746-6969

165 Wadsworth Dr
North Chesterfield, VA 23236
Phone (804) 272-9146

215 Wadsworth Dr
North Chesterfield, VA 23236
Phone (804) 497-4973

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

1600 Wilkes Ridge Dr
Ste 100
Richmond, VA 23233
Phone (703) 563-0042

2369 Staples Mill Rd
Ste 100
Richmond, VA 23230
Phone (804) 354-8818

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

Organizations & group practices 5

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": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1427389709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DR",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VI",
            "postal_code": "220332921",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "23805",
            "telephone_number": "804-765-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYREE",
        "first_name": "DIONNE",
        "middle_name": "MICHELLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024168660",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001138871",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427389709",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.