Individual provider Active NPI

Anne Marie Bombardier, CRNA

  • Certified Registered Nurse Anesthetist
  • Coos Bay, OR
National Provider Identifier
1750561650
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201701964CRNA Issued in OR
Practice address
1900 Woodland Dr
Coos Bay, OR 97420-2099
Phone
(541) 267-5151
Fax
(541) 266-4560
NPI assigned
Nov 7, 2007
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 183804 CO
Certified Registered Nurse Anesthetist 367500000X 201701964CRNA OR Primary

Addresses

Primary practice location

1900 Woodland Dr
Coos Bay, OR 97420-2099

Mailing address

1900 Woodland Dr
Coos Bay, OR 97420-2099
Phone (541) 267-5151

Other names 1

  • Anne Marie Moeckly Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170428001213 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163505470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.45 of 100Reported as group
Quality
69.6
Promoting interoperability
100
Improvement activities
40
Cost
76.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
183804COMDCertified Registered Nurse Anesthetist
201701964CRNAORMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Bend Medical Center Inc CurrentSince Apr 3, 2025 Accepting new patients
Bay Area Hospital District CurrentSince Apr 5, 2017 Accepting new patients
Bay Area Hospital District Nurse Anesthetist, Certified Registered CurrentSince Apr 5, 2017 Accepting new patients
North Bend Medical Center Inc CurrentSince Apr 3, 2025 Accepting new patients
Matthew J Furman, D.O. LLC Past Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1750561650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202099",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202099",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBARDIER",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "183804",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201701964CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "MOECKLY",
            "middle_name": "MARIE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.