Individual provider Active NPI

Tracey W Yeaman, CRNA

  • Certified Registered Nurse Anesthetist
  • Danville, VA
National Provider Identifier
1568778892
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0001170056 Issued in VA
Practice address
142 S Main St
Danville, VA 24541-2922
Phone
(434) 799-2375
NPI assigned
Aug 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 71986 WV
Certified Registered Nurse Anesthetist 367500000X 0001170056 VA Primary

Addresses

Primary practice location

142 S Main St
Danville, VA 24541-2922

Mailing address

142 S Main St
Danville, VA 24541-2922
Phone (434) 799-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110817000025 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618146291 Reassigns benefits to 1 organization
I20180308001654 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618146291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

142 S Main St
Danville, VA 24541-2922
Phone (434) 799-3839

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
71986WVMDRegistered Nurse
0001170056VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 26, 2018 Accepting new patients
Gate City Anesthesia, Inc CurrentSince Nov 13, 2017 Accepting new patients

Locations

705 Green Valley Rd
Greensboro, NC 27408
Phone (336) 272-0012

21A Oak Branch Dr
Greensboro, NC 27407
Phone (336) 478-2664

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

6801 Governor Gc Peery Hwy
Richlands, VA 24641
Phone (276) 523-8600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1568778892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 S MAIN ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245412922",
            "telephone_number": "434-799-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 S MAIN ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245412922",
            "telephone_number": "434-799-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAMAN",
        "first_name": "TRACEY",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "71986",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001170056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.