Cloud Nine Anesthesia PA

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

C02646 Issued in AR

Legal business name

CLOUD NINE ANESTHESIA PA

Practice address

9101 Kanis Rd Ste 300
Little Rock, AR 72205-6453

Phone

(501) 771-4370

Fax

(501) 327-9722

NPI assigned

May 27, 2009

Last updated

May 27, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy Lynn Davenport, CRNANPI 1053489344

Title

Owner

Phone

(501) 442-1640

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Tracy Lynn Davenport, CRNA

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
  • NPI 1053489344
  NPD (past) Authorized official

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1790910255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 PLANTATION DR",
            "city": "MAYFLOWER",
            "state": "AR",
            "postal_code": "721068420",
            "telephone_number": "501-771-4370",
            "fax_number": "501-327-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 KANIS RD STE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056453",
            "telephone_number": "501-771-4370",
            "fax_number": "501-327-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOUD NINE ANESTHESIA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-442-1640",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "C02646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clinical Psychology Services, Inc.
• Erika Dawn Clinton
• Charles W Clogston, M.D.
• Jeffrey Lane Clothier, MD
• Cloud Family Dental
• John Justus Cloud, DDS
• Kate Elizabeth Cloud, CRNA
• Michael Carl Cloud, M.D.
• W. Lindsay Cloud III, DMD
• Lauren Clow, CRNA

• Anesthesiology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Anesthesiology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.