Individual provider Active NPI

Thomas H Downey, CRNA

  • Certified Registered Nurse Anesthetist
  • Martinsburg, WV
National Provider Identifier
1750377263
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
36356 Issued in WV
Practice address
1006 Tavern Rd
Martinsburg, WV 25401-2864
Phone
(304) 267-5141
Fax
(304) 267-5140
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 36356 WV Primary

Addresses

Primary practice location

1006 Tavern Rd
Martinsburg, WV 25401-2864

Mailing address

PO Box 62556
Baltimore, MD 21264-2556
Phone (866) 709-4485

Other identifiers 3

IdentifierTypeStateIssuer
038457OtherAANA NUMBER
P00936032OtherWVRAILROAD MEDICARE
0068796000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050128000229 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678523594 Reassigns benefits to 1 organization
I20200330003875 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678523594 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36356WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jan 13, 2020 Accepting new patients
Tri-State Surgical Center, LLC CurrentSince Sep 1, 2020 Accepting new patients
Tri-State Surgical Center, LLC CurrentSince Sep 1, 2020 Accepting new patients
Wellspan Medical Group CurrentSince Jan 13, 2020 Accepting new patients
Blue Ridge Anesthesia Associates LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1006 Tavern Rd
Ste A
Martinsburg, WV 25401
Phone (304) 267-0556

1006 Tavern Rd
Martinsburg, WV 25401
Phone (304) 267-0556

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1750377263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62556",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642556",
            "telephone_number": "866-709-4485",
            "fax_number": "302-733-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 TAVERN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012864",
            "telephone_number": "304-267-5141",
            "fax_number": "304-267-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOWNEY",
        "first_name": "THOMAS",
        "middle_name": "H",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "36356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANA NUMBER",
            "identifier": "038457",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00936032",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068796000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; 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.