Active NPI
Anesthesia Associates of Williamsport, Inc
- Anesthesiology Physician
- Williamsport, PA
National Provider Identifier
1467410191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- ANESTHESIA ASSOCIATES OF WILLIAMSPORT, INC
- Practice address
- 777 Rural Ave
Williamsport, PA 17701-3109 - Phone
- (570) 322-7092
- NPI assigned
- May 3, 2006
- Last updated
- Nov 8, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tim Pastore, MD
- Title
- President
- Phone
- (570) 322-7092
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | NU | Primary |
Addresses
Primary practice location
777 Rural Ave
Williamsport, PA 17701-3109
Mailing address
804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone (800) 394-4445
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0011610060007 | Medicaid | PA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1194480000000",
"number": "1467410191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 SCOTT NIXON MEMORIAL DR",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309072464",
"telephone_number": "800-394-4445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 RURAL AVE",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177013109",
"telephone_number": "570-322-7092"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ANESTHESIA ASSOCIATES OF WILLIAMSPORT, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-03",
"last_updated": "2007-11-08",
"status": "A",
"authorized_official_last_name": "PASTORE",
"authorized_official_first_name": "TIM",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "570-322-7092",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0011610060007",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.