Individual provider Active NPI

Charlene M. Anderson, CRNA

  • Certified Registered Nurse Anesthetist
  • Allentown, PA
National Provider Identifier
1730176629
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
040491 Issued in PA
Practice address
400 N 17TH St
Allentown, PA 18104-5052
Phone
(610) 402-9099
Fax
(610) 402-9029
NPI assigned
Oct 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN266339L PA
Certified Registered Nurse Anesthetist 367500000X 040491 PA Primary

Addresses

Primary practice location

400 N 17TH St
Allentown, PA 18104-5052

Mailing address

24 S 18TH Street
Allentown, PA 18104-5622
Phone (610) 628-8372

Other identifiers 10

IdentifierTypeStateIssuer
0063046OtherPAFIRST PRIORITY
0063046OtherPAHIGHMARK
0063046OtherPAKHP CENTRAL
9699193OtherPAAETNA
0070312970003MedicaidPA
01484202OtherPACAPITAL ADVANTAGE
0718259000OtherPAINDEP. BLUE CROSS
11766001OtherPACAQH
1585085OtherPAGATEWAY
82832OtherPAGEISINGER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080327000024 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668558958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
LVPG General in Patient Pediatrics
Allentown, PA 18103-6202
Phone (610) 402-6700

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN266339LPAMDRegistered Nurse
040491PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Anesthesia Services, P. C. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2002 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 28, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 28, 2023 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients

Locations

400 N 17th St
Allentown, PA 18104
Phone (610) 402-9099

1251 S Cedar Crest Blvd
Ste 212C
Allentown, PA 18103
Phone (610) 402-8810

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

1245 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 402-9080

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1730176629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 S 18TH STREET",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045622",
            "telephone_number": "610-628-8372",
            "fax_number": "610-628-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N 17TH ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045052",
            "telephone_number": "610-402-9099",
            "fax_number": "610-402-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHARLENE",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN266339L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "040491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "0063046",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "0063046",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHP CENTRAL",
            "identifier": "0063046",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9699193",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070312970003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL ADVANTAGE",
            "identifier": "01484202",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEP. BLUE CROSS",
            "identifier": "0718259000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11766001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1585085",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "82832",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.