NPIMap

Organization Active NPI

Green Anesthesia

  • Certified Registered Nurse Anesthetist
  • Fairfield, CA
National Provider Identifier
1457039331
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
GREEN ANESTHESIA
Practice address
2700 Low CT FL 2
Fairfield, CA 94534-9778
Phone
(707) 432-2700
NPI assigned
Jul 10, 2023
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Lyn Green, CRNANPI 1013348903
Title
Owner
Phone
(775) 747-5050

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

Practitioners 64

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

View all 64

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231004000338 CA Part B Supplier - Clinic/Group Practice 6103270566 Receives reassigned benefits from 64 practitioners
Practice locations: Yuba City, CA; Vacaville, CA; Sacramento, CA; Roseville, CA; Redding, CA; Jackson, CA; Fairfield, CA; Elk Grove, CA…

National Provider Directory

National Provider Directory

Locations

223 Clinton Rd
Ste 204
Jackson, CA 95642
Phone (209) 223-5938

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

2700 Low CT FL 2
Fairfield, CA 94534-9778

Mailing address

PO Box 34120
Reno, NV 89533-4120

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 10, 2023.

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1457039331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34120",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895334120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 LOW CT FL 2",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945349778",
            "telephone_number": "707-432-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-747-5050",
        "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 Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.