Individual provider Active NPI

David Lynn Proffer, CRNA

  • Certified Registered Nurse Anesthetist
  • Seymour, IN
National Provider Identifier
1780854802
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28175002A Issued in IN
Practice address
411 W Tipton St
Seymour, IN 47274-2363
Phone
(812) 522-0429
NPI assigned
Mar 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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 28175002A IN Primary

Addresses

Primary practice location

411 W Tipton St
Seymour, IN 47274-2363

Mailing address

411 W Tipton St
Seymour, IN 47274-2363
Phone (812) 522-0429

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080404000214 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577640333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as apm
Quality
85.1
Promoting interoperability
94.69
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28175002AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Schneck Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Feb 18, 2008 Accepting new patients
Seymour Indiana Pathologists, Inc Past Accepting new patients
Jackson County Schneck Memorial Hospital Past Accepting new patients

Locations

200 S Walnut St
Seymour, IN 47274
Phone (812) 522-2349

411 W Tipton St
Seymour, IN 47274
Phone (317) 888-3505

Organizations & group practices 3

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": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1780854802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742363",
            "telephone_number": "812-522-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W TIPTON ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742363",
            "telephone_number": "812-522-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFFER",
        "first_name": "DAVID",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28175002A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.