Individual provider Active NPI

Sandra K McDonald, CRNA

  • Certified Registered Nurse Anesthetist
  • Huntington, WV
National Provider Identifier
1811078470
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
30341 Issued in WV
Practice address
1340 Hal Greer Blvd
Huntington, WV 25701-3800
Phone
(205) 322-1808
Fax
(205) 322-1851
NPI assigned
Oct 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 30341 WV Primary

Addresses

Primary practice location

1340 Hal Greer Blvd
Huntington, WV 25701-3800

Mailing address

PO Box 714960
Columbus, OH 43271-4960
Phone (205) 322-1808

Other identifiers 5

IdentifierTypeStateIssuer
1056111OtherWVWORKERS' COMP
74414640MedicaidKY
0067951000MedicaidWV
0868833MedicaidOH
P00209264OtherPALMETTO GBA-RR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050524001075 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547202160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of West Virginia PLLCGroup PAC ID 2668750241, 124 clinicians

Practice addresses (Care Compare)

1340 Hal Greer Blvd
Huntington, WV 25701-3804
Phone (304) 526-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30341WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cabell Huntington Hospital Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2005 Accepting new patients
Cabell Huntington Hospital Inc CurrentSince Mar 1, 2005 Accepting new patients
Northstar Anesthesia of West Virginia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 12, 2016 Accepting new patients
Mid-Atlantic Anesthesia Consultants, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Day Surgery Limited Liability Past Accepting new patients
Professional Anesthesia Service,Inc. Past Accepting new patients
Day Surgery Limited Liability Past Accepting new patients

Locations

1201 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 523-1885

1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811078470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 714960",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432714960",
            "telephone_number": "205-322-1808",
            "fax_number": "205-322-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013800",
            "telephone_number": "205-322-1808",
            "fax_number": "205-322-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "SANDRA",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "30341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS' COMP",
            "identifier": "1056111",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74414640",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067951000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0868833",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RR MEDICARE",
            "identifier": "P00209264",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.