NPIMap

Organization Active NPI

Goodnight Moon Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Yukon, OK
National Provider Identifier
1730649716
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
GOODNIGHT MOON ANESTHESIA PLLC
Practice address
1600 Garth Brooks Blvd Ste 150
Yukon, OK 73099-7412
Phone
(405) 578-5234
NPI assigned
Mar 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Authorized official

Name
Judy Payne
Title
Admin
Phone
(904) 387-4778

Specialties & licenses 1

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

Addresses

Primary practice location

1600 Garth Brooks Blvd Ste 150
Yukon, OK 73099-7412

Mailing address

12501 Bradford Farms LN
Edmond, OK 73025-8621

Other names 1

  • AMBER JONES APRN-CRNA PLLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190812001188 OK Part B Supplier - Clinic/Group Practice 5799012902 Receives reassigned benefits from 4 practitioners
Practice locations: Oklahoma City, OK; Yukon, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1730649716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 BRADFORD FARMS LN",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730258621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 GARTH BROOKS BLVD STE 150",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997412",
            "telephone_number": "405-578-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODNIGHT MOON ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "904-387-4778"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMBER JONES APRN-CRNA PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Yukon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.