NPIMap

Organization Active NPI

Ecgj Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Grand Junction, CO
National Provider Identifier
1609120070
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ECGJ ANESTHESIA LLC
Practice address
1035 Wellington Ave
Grand Junction, CO 81501-8122
Phone
(615) 346-5879
Fax
(615) 346-5879
NPI assigned
Nov 6, 2012
Last updated
Jun 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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

Authorized official

Name
Mr. Chad L Stevens
Title
President Board of Managers
Phone
(615) 345-6868

Specialties & licenses 1

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

Addresses

Primary practice location

1035 Wellington Ave
Grand Junction, CO 81501-8122

Mailing address

401 Commerce St
Ste 600
Nashville, TN 37219-2446
Phone (615) 843-4102

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130314000349 CO Part B Supplier - Clinic/Group Practice 9133364466 Receives reassigned benefits from 33 practitioners
Practice locations: Grand Junction, CO

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498694400000",
    "number": "1609120070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 COMMERCE ST",
            "address_2": "STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372192446",
            "telephone_number": "615-843-4102",
            "fax_number": "615-691-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 WELLINGTON AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018122",
            "telephone_number": "615-346-5879",
            "fax_number": "615-346-5879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECGJ ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2017-06-29",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT BOARD OF MANAGERS",
        "authorized_official_telephone_number": "615-345-6868",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; 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.