Individual provider Active NPI

Teresa Lynn Toombs, CRNA

  • Certified Registered Nurse Anesthetist
  • Tahlequah, OK
National Provider Identifier
1770581001
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
572751 Issued in TX
Practice address
1400 E Downing St
Tahlequah, OK 74464-3324
Phone
(918) 453-2148
NPI assigned
Jul 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 93952 OK
Certified Registered Nurse Anesthetist 367500000X 4704279215 MI
Certified Registered Nurse Anesthetist 367500000X 572751 TX Primary

Addresses

Primary practice location

1400 E Downing St
Tahlequah, OK 74464-3324

Mailing address

PO Box 579
Park Hill, OK 74451-0579
Phone (918) 772-0990

Other identifiers 8

IdentifierTypeStateIssuer
88460UOtherTXBCBS
154341701MedicaidAR
4308712170OtherMIBCBS
166116702MedicaidTX
1770581001MedicaidMI
82710OtherARBLUE CROSS
83898UOtherTXBLUE CROSS
166116701MedicaidTX

Other names 1

  • Tracy L Toombs Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK, KS, MO4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20040609001370 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355324500 Reassigns benefits to 4 organizations
I20090302000273 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355324500 Reassigns benefits to 1 organization
I20180227002906 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355324500
I20180417002226 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355324500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Health SystemGroup PAC ID 1456255025, 105 clinicians

Practice addresses (Care Compare)

1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704279215MIMDCertified Registered Nurse Anesthetist
93952OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Health System CurrentSince Nov 2, 2009 Accepting new patients
Methodist Hospital Plainview Texas CurrentSince Feb 3, 2012 Accepting new patients
Northstar Anesthesia of Missouri, LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2018 Accepting new patients
Anesthesia Associates of Grand Lake CurrentSince Oct 1, 2018 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Nov 18, 2017 Accepting new patients
Northstar Anesthesia II PA Nurse Anesthetist, Certified Registered CurrentSince Dec 17, 2018 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Jul 11, 2011 Accepting new patients
Northeastern Health System CurrentSince Nov 2, 2009 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Jul 11, 2011 Accepting new patients
Methodist Hospital Plainview Texas CurrentSince Feb 3, 2012 Accepting new patients
Boiling Springs Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Medical Center Medical Group Past Accepting new patients

Locations

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1400 E Downing St
Tahlequah, OK 74464
Phone (918) 456-0641

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

7101 S Padre Island Dr
Corpus Christi, TX 78412
Phone (361) 761-1400

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

2606 Yonkers St
Plainview, TX 79072
Phone (806) 291-5120

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

1000 Pine St
Texarkana, TX 75501
Phone (903) 798-7365

Organizations & group practices 12

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1770581001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "PARK HILL",
            "state": "OK",
            "postal_code": "744510579",
            "telephone_number": "918-772-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E DOWNING ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643324",
            "telephone_number": "918-453-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOOMBS",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "93952",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704279215",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "572751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "88460U",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154341701",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4308712170",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166116702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770581001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "82710",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "83898U",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166116701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "TOOMBS",
            "middle_name": "L",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.