Individual provider Active NPI

Dana Sue Coffman, CRNA

  • Certified Registered Nurse Anesthetist
  • Davenport, IA
National Provider Identifier
1578727715
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D116964 Issued in IA
Practice address
3400 Dexter CT
Suite 101
Davenport, IA 52807-3461
Phone
(563) 344-6746
Fax
(563) 344-6740
NPI assigned
Jul 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X D116964 IA Primary

Addresses

Primary practice location

3400 Dexter CT
Suite 101
Davenport, IA 52807-3461

Mailing address

8315 47TH St
Milan, IL 61264-3263
Phone (309) 333-9070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100616000619 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193855278 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 16, 2013 Accepting new patients

Locations

3400 Dexter Ct
Ste 200
Davenport, IA 52807
Phone (563) 344-6600

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1578727715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8315 47TH ST",
            "city": "MILAN",
            "state": "IL",
            "postal_code": "612643263",
            "telephone_number": "309-333-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DEXTER CT",
            "address_2": "SUITE 101",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073461",
            "telephone_number": "563-344-6746",
            "fax_number": "563-344-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "DANA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-16",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D116964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.