Individual provider Active NPI

Audrey L. Culbertson, CRNA

  • Certified Registered Nurse Anesthetist
  • Lebanon, VA
National Provider Identifier
1629078209
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024166232 Issued in VA
Practice address
Carrol and Tate Street
Lebanon, VA 24266
Phone
(276) 883-8330
Fax
(276) 889-4336
NPI assigned
Jul 26, 2005
Last updated
Jul 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024166232 VA Primary
Anesthesiology Physician 207L00000X 0024166232 VA

Addresses

Primary practice location

Carrol and Tate Street
Lebanon, VA 24266

Mailing address

Carrol and Tate Street
Lebanon, VA 24266
Phone (276) 883-8330

Other names 1

  • Audrey Ratliff Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000285 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022076678 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Highlands Anesthesia PCGroup PAC ID 0648266437, 29 clinicians
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

100 15TH St NW
Norton, VA 24273-1616
Phone (276) 679-9600

16000 Johnson Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-1000

6801 Gov GC Peery Hwy
Richlands, VA 24641-2194
Phone (276) 596-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9245TNMDClinical Social Worker
0024166232VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Anesthesiology CurrentSince Jun 3, 2013 Accepting new patients
Russell County Medical Center Inc Past Accepting new patients

Locations

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

Organizations & group practices 3

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

Hospital & facility affiliations 1

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1629078209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CARROL AND TATE STREET",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-883-8330",
            "fax_number": "276-889-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARROL AND TATE STREET",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-883-8330",
            "fax_number": "276-889-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULBERTSON",
        "first_name": "AUDREY",
        "middle_name": "L.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024166232",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0024166232",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "RATLIFF",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lebanon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.