NPIMap

Organization Active NPI

South Arkansas Anesthesia Associates, LLC

  • Certified Registered Nurse Anesthetist
  • El Dorado, AR
National Provider Identifier
1568599892
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R48530 Issued in AR
Legal business name
SOUTH ARKANSAS ANESTHESIA ASSOCIATES, LLC
Practice address
2704 Vine St
El Dorado, AR 71730
Phone
(501) 227-0700
Fax
(501) 227-0744
NPI assigned
Feb 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Paula A Keys, CPC, CCP
Title
Manager
Phone
(501) 227-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R48530 AR Primary

Addresses

Primary practice location

2704 Vine St
El Dorado, AR 71730

Mailing address

PO Box 55990
Little Rock, AR 72215-5990
Phone (501) 227-0700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080128000287 AR Part B Supplier - Clinic/Group Practice 2264514488 Receives reassigned benefits from 6 practitioners
Practice locations: Magnolia, AR; El Dorado, AR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568599892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55990",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722155990",
            "telephone_number": "501-227-0700",
            "fax_number": "501-227-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 VINE ST",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "71730",
            "telephone_number": "501-227-0700",
            "fax_number": "501-227-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ARKANSAS ANESTHESIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEYS",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "501-227-0700",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPC, CCP"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "R48530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.