Organization Active NPI

Tisue Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • Decorah, IA
National Provider Identifier
1720051592
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
TISUE ANESTHESIA SERVICES
Practice address
901 Montgomery St
Decorah, IA 52101-2325
Phone
(319) 382-2911
NPI assigned
Feb 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Bill Tisue, CRNA
Title
Partner
Phone
(563) 382-1580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

901 Montgomery St
Decorah, IA 52101-2325

Mailing address

400 E 10TH St
Waconia, MN 55387-4552
Phone (952) 442-9770

Other identifiers 2

IdentifierTypeStateIssuer
0151928MedicaidIA
36893OtherIABLUE CROSS OF IA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1720051592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 10TH ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MONTGOMERY ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012325",
            "telephone_number": "319-382-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TISUE ANESTHESIA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "TISUE",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "563-382-1580",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0151928",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IA",
            "identifier": "36893",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decorah, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.