NPIMap

Organization Active NPI

Surgical Anesthesia of Norfolk LLC

  • Anesthesiology Physician
  • Norfolk, NE
National Provider Identifier
1639168206
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SURGICAL ANESTHESIA OF NORFOLK LLC
Practice address
3400 W Norfolk Ave
Norfolk, NE 68701-7701
Phone
(308) 382-7744
Fax
(308) 382-7744
NPI assigned
Oct 17, 2005
Last updated
Oct 3, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Authorized official

Name
Christy L Rivera
Title
Office Manager
Phone
(308) 382-7744

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU

Addresses

Primary practice location

3400 W Norfolk Ave
Norfolk, NE 68701-7701

Mailing address

PO Box 1611
Surgical Anesthesia of Norfolk LLC
Norfolk, NE 68702-1611
Phone (308) 382-7744

Other identifiers 2

IdentifierTypeStateIssuer
10024970800MedicaidNE
10025009800MedicaidNE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1639168206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1611",
            "address_2": "SURGICAL ANESTHESIA OF NORFOLK LLC",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687021611",
            "telephone_number": "308-382-7744",
            "fax_number": "308-382-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W NORFOLK AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687017701",
            "telephone_number": "308-382-7744",
            "fax_number": "308-382-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ANESTHESIA OF NORFOLK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "308-382-7744"
    },
    "taxonomies": [
        {
            "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10024970800",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025009800",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.