NPIMap

Organization Active NPI

Greater Siouxland Anesthesiology & Pain Prof LLC

  • Certified Registered Nurse Anesthetist
  • South Sioux City, NE
National Provider Identifier
1750916490
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
GREATER SIOUXLAND ANESTHESIOLOGY & PAIN PROF LLC
Practice address
201 E 4TH St
South Sioux City, NE 68776-1706
Phone
(888) 209-0305
Fax
(952) 442-3620
NPI assigned
Mar 3, 2020
Last updated
Mar 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Authorized official

Name
Dustin J Delaney, CRNANPI 1801186721
Title
President
Phone
(605) 413-9398

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

201 E 4TH St
South Sioux City, NE 68776-1706

Mailing address

400 10TH St E
Waconia, MN 55387-4552
Phone (888) 209-0305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, SD, IA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20200413000652 NE Part B Supplier - Clinic/Group Practice 5395174478 Receives reassigned benefits from 33 practitioners
Practice locations: South Sioux City, NE
O20220318000634 SD Part B Supplier - Clinic/Group Practice 5395174478 Receives reassigned benefits from 3 practitioners
Practice locations: Dakota Dunes, SD
O20250610001721 IA Part B Supplier - Clinic/Group Practice 5395174478 Receives reassigned benefits from 1 practitioner
Practice locations: Sioux City, IA

National Provider Directory

National Provider Directory

Locations

2730 Pierce St
Ste 100
Sioux City, IA 51104
Phone (712) 294-7693

317 Dakota Dunes Blvd
Ste G
Dakota Dunes, SD 57049
Phone (712) 251-6445

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1750916490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 10TH ST E",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "888-209-0305",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 4TH ST",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687761706",
            "telephone_number": "888-209-0305",
            "fax_number": "952-442-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER SIOUXLAND ANESTHESIOLOGY & PAIN PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "DELANEY",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-413-9398",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Sioux City, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.