Organization Active NPI

Anesthesia Associates of Williamsport, Inc

  • Anesthesiology Physician
  • Williamsport, PA
National Provider Identifier
1467410191
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
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, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0011610060007MedicaidPA

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.