Estes Valley Anesthesia LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

CRA-2933 Issued in CO

Legal business name

ESTES VALLEY ANESTHESIA LLC

Practice address

850 North LN
Estes Park, CO 80517-9629

Phone

(970) 443-8855

NPI assigned

May 12, 2011

Last updated

May 12, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jason Goodwin, CRNA

Title

Owner

Phone

(970) 443-8855

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1679865372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 NORTH LN",
            "city": "ESTES PARK",
            "state": "CO",
            "postal_code": "805179629",
            "telephone_number": "970-443-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 NORTH LN",
            "city": "ESTES PARK",
            "state": "CO",
            "postal_code": "805179629",
            "telephone_number": "970-443-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTES VALLEY ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-443-8855",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "CRA-2933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17228042",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID FOR JASON GOODWIN",
            "identifier": "C188438",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID FOR MARY BOLGEO",
            "identifier": "C802029",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52909361",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Estes Park Chiropractic LLC
• Estes Park Emergency Associates
• Estes Park Pharmacy Inc
• Estes Park Physical Therapy PLLC
• Estes Park Takxi LLC (Non Emergency Transportation)
• Hannah Elena Schwartz Fields, M.D.
• Fire Mountain Residential Treatment Center, Inc.
• Eileen Flaherty, NP
• Paul W Fonken, M.D.
• Nicole Frens

• Certified Registered Nurse Anesthetist in Estes Park, CO
• Providers in Estes Park, CO by specialty
• Certified Registered Nurse Anesthetist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.