Individual provider Active NPI

Sandra G Davis, CRNA

  • Certified Registered Nurse Anesthetist
  • Providence, RI
National Provider Identifier
1851355606
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA36737 Issued in RI
Practice address
593 Eddy Street
Davol 129
Providence, RI 02903-4923
Phone
(401) 444-4933
Fax
(401) 444-5083
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024166061 VA
Certified Registered Nurse Anesthetist 367500000X RNA36737 RI Primary

Addresses

Primary practice location

593 Eddy Street
Davol 129
Providence, RI 02903-4923

Mailing address

75 Newman Avenue
Suite 100
Rumford, RI 02916-1945
Phone (401) 453-0666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
340AKMDPhysician Assistant
0024166061VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cap Anesthesia, PC Past Accepting new patients
Childrens Specialty Group PLLC Past Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients
Virginia Anesthesia and Perioperative Care Specialists LLC Past Accepting new patients
Capa Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 5

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1851355606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 NEWMAN AVENUE",
            "address_2": "SUITE 100",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029161945",
            "telephone_number": "401-453-0666",
            "fax_number": "401-435-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY STREET",
            "address_2": "DAVOL 129",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4933",
            "fax_number": "401-444-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SANDRA",
        "middle_name": "G",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024166061",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "RI",
            "license": "RNA36737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.