NPIMap

Organization Active NPI

Professional Anesthesia Group, LLC

  • Anesthesiology Physician
  • Fredericksburg, VA
National Provider Identifier
1619149648
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PROFESSIONAL ANESTHESIA GROUP, LLC
Practice address
1500 Dixon St Ste 101
Fredericksburg, VA 22401-7231
Phone
(540) 371-5349
Fax
(540) 373-1745
NPI assigned
Mar 31, 2008
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Brian P Woods, MD
Title
Chief Medical Officer
Phone
(214) 687-0015

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU

Addresses

Primary practice location

1500 Dixon St Ste 101
Fredericksburg, VA 22401-7231

Mailing address

PO Box 222037
Dallas, TX 75222-2037
Phone (239) 610-0775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090122000416 VA Part B Supplier - Clinic/Group Practice 8527133677 Receives reassigned benefits from 135 practitioners
Practice locations: Virginia Beach, VA; Richmond, VA; Fredericksburg, VA; Chesapeake, VA

National Provider Directory

National Provider Directory

Locations

1302 Rising Ridge Rd
Ste 1
Mount Airy, MD 21771

1501 Maple Ave
Richmond, VA 23226
Phone (804) 287-7878

1501 Maple Ave
Ste 300
Richmond, VA 23226
Phone (804) 287-7878

828 Healthy Way
Virginia Beach, VA 23462
Phone (757) 395-1960

Practitioners & affiliated clinicians

Practitioners 160

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 160

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1619149648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222037",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752222037",
            "telephone_number": "239-610-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DIXON ST STE 101",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224017231",
            "telephone_number": "540-371-5349",
            "fax_number": "540-373-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ANESTHESIA GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "214-687-0015",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.