Organization Active NPI

Icare Anesthesia Services LLC

  • Certified Registered Nurse Anesthetist
  • Las Cruces, NM
National Provider Identifier
1497408199
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ICARE ANESTHESIA SERVICES LLC
Practice address
1205 S Telshor Blvd
Las Cruces, NM 88011-4748
Phone
(573) 686-5550
NPI assigned
Feb 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Authorized official

Name
Ike Iyamu, CRNA
Title
Managing Member
Phone
(573) 686-5550

Specialties & licenses 1

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

Addresses

Primary practice location

1205 S Telshor Blvd
Las Cruces, NM 88011-4748

Mailing address

2511 N Westwood Blvd Ste B
Poplar Bluff, MO 63901-2303
Phone (573) 686-5550

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643760000000",
    "number": "1497408199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 N WESTWOOD BLVD STE B",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012303",
            "telephone_number": "573-686-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114748",
            "telephone_number": "573-686-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICARE ANESTHESIA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A",
        "authorized_official_last_name": "IYAMU",
        "authorized_official_first_name": "IKE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "573-686-5550",
        "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 Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; 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.