Lynn A Peterson, MSN, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP30006221 Issued in WA

Practice address

714 W Pine St
Newport, WA 99156-9046

Phone

(509) 447-2441

Fax

(509) 447-2281

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Master of Science - Nursing

Practice roles

Locations

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

• Assurant Anesthesia Associates Inc

  • Anesthesiology Physician
  • Kailua Kona, HI
  • NPI 1972215358
  Medicare reassignment NPD
• Medstream Anesthesia Hawaii, LLC

  • Anesthesiology Physician
  • Kamuela, HI
  • NPI 1346621190

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Pend Oreille County Public Hospital District No 1

  • Community/Retail Pharmacy
  • Newport, WA
  • NPI 1134831415
  NPD
• Pend Oreille County Public Hospital District No 1

  • Emergency Medicine Physician
  • Newport, WA
  • NPI 1427264795
  NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1720165160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 S JEFFERSON DR",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992031421",
            "telephone_number": "509-220-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W PINE ST",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "991569046",
            "telephone_number": "509-447-2441",
            "fax_number": "509-447-2281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LYNN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MSN, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30006221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "G000381050",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00395894",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP NUMBER",
            "identifier": "CG4026",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9636465",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pend Oreille Fire 3
• Pend Oreille Paramedics
• Pend Oreille River Emergency Physicians PLLC
• Elizabeth Peters
• Aaron Petersen, MD
• Molly O Phillips, LICMSW
• Steven Price, PHYSICAL THERAPIST A
• Shannon B Radke, M.D.
• Mary Jane Ramirez
• Cody March Windell Reed

• Certified Registered Nurse Anesthetist in Newport, WA
• Providers in Newport, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.