NPIMap

Organization Active NPI

Crossett Health Foundation

Doing business as Ashley County Anesthesia

  • Certified Registered Nurse Anesthetist
  • Crossett, AR
National Provider Identifier
1508821547
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
CROSSETT HEALTH FOUNDATION
Doing business as
Ashley County Anesthesia
Practice address
1015 Unity Rd
Crossett, AR 71635-9443
Phone
(870) 364-1280
NPI assigned
Apr 20, 2006
Last updated
Mar 17, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
CROSSETT HEALTH FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Russ Sword
Title
Cfo
Phone
(870) 364-1280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

1015 Unity Rd
Crossett, AR 71635-9443

Mailing address

400 E 10TH St
Waconia, MN 55387-4552
Phone (952) 442-9770

Other identifiers 1

IdentifierTypeStateIssuer
5C503OtherARBLUE CROSS OF AR

Other names 1

  • ASHLEY COUNTY ANESTHESIA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080628000105 AR Part B Supplier - Clinic/Group Practice 9133030117 Receives reassigned benefits from 7 practitioners
Practice locations: Crossett, AR

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ashley Memorial Hospita9 organizations share this tax ID, including this one
Part of
Ashley Memorial Hospita

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ashley County Medical CenterCrossett, AR, CCN 041323 Hospital 5% Or Greater Direct Ownership Interest Aug 1, 1945
Ashley County Medical CenterCrossett, AR, CCN 04Z323 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1998
Ashley Health ServicesCrossett, AR, CCN 043490 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control (100%)		 Dec 1, 2001
Dec 1, 2001
Hamburg Health ClinicHamburg, AR, CCN 048501 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2012

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1508821547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 10TH ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 UNITY RD",
            "city": "CROSSETT",
            "state": "AR",
            "postal_code": "716359443",
            "telephone_number": "870-364-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSETT HEALTH FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CROSSETT HEALTH FOUNDATION",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "SWORD",
        "authorized_official_first_name": "RUSS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-364-1280"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF AR",
            "identifier": "5C503",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASHLEY COUNTY ANESTHESIA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crossett, AR

Sources for this page

Verify at the official NPI Registry.