Island Anesthesia, PC

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

311030-4406 Issued in UT

Legal business name

ISLAND ANESTHESIA, PC

Practice address

1311 N Mildred Rd
Cortez, CO 81321-2231

Phone

(970) 564-2152

NPI assigned

May 6, 2009

Organization subpart

No

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

Authorized official

Name

Mark Enosa Wilson, CRNA

Title

President

Phone

(801) 949-2629

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260144000000",
    "number": "1609000520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813210636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N MILDRED RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212231",
            "telephone_number": "970-564-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND ANESTHESIA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2009-12-07",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ENOSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-949-2629",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "UT",
            "license": "311030-4406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Insight Therapy, LLC
• Integrated Insight Therapy, LLC
• Integrated Insight Therapy, LLC
• Intermountain Medical Group Grand Junction, LLC
• Erick Ireland, PA-C
• Richard M Jacobsen
• John J Black DDS, Inc.
• Johnson Physical Therapy and Rehab PC
• Najib Chapman Johnson, P.T.
• Penny Johnson, LPN

• All providers in Cortez, CO
• Critical Access Hospital in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.