Individual provider Active NPI

Drew Ayn Peterson, APRN-CRNA

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1750893541
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
103070 Issued in OK
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone
(918) 494-2200
NPI assigned
Nov 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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 103070 OK
Certified Registered Nurse Anesthetist 367500000X 103070 OK Primary

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1902

Mailing address

4017 S Columbia PL
Tulsa, OK 74105-8236
Phone (918) 497-0980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180131002736 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820358310 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sooner Anesthesia Services LLCGroup PAC ID 7416919899, 18 clinicians

Practice addresses (Care Compare)

4808 S 109TH E Ave
Tulsa, OK 74146-5822
Phone (918) 742-2502

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103070OKMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia Management Inc CurrentSince Jul 18, 2022 Accepting new patients
H&H Medical Services, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2021 Accepting new patients
Osh Aai PLLC CurrentSince Dec 25, 2017 Accepting new patients
Sooner Anesthesia Services LLC CurrentSince Dec 6, 2025 Accepting new patients

Locations

1150 E Lansing St
Broken Arrow, OK 74012
Phone (918) 258-9111

209 S 36th St
Muskogee, OK 74401
Phone (918) 682-7717

3800 W Okmulgee St
Muskogee, OK 74401
Phone (918) 682-9899

Dept 2876
Tulsa, OK 74182

6839 S Canton Ave
Tulsa, OK 74136
Phone (918) 494-0612

5801 E 41st St
Ste 801
Tulsa, OK 74135
Phone (918) 504-9686

4800 S 109th East Ave
Tulsa, OK 74146
Phone (918) 742-2502

4808 S 109th East Ave
Tulsa, OK 74146
Phone (918) 392-1513

Organizations & group practices 4

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": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1750893541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4017 S COLUMBIA PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741058236",
            "telephone_number": "918-497-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-494-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DREW",
        "middle_name": "AYN",
        "credential": "APRN-CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "103070",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "103070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.