Individual provider Active NPI

Daniel Charles Simonson, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Spokane Valley, WA
National Provider Identifier
1861485021
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP30004926 Issued in WA
Practice address
16818 E Desmet CT
Spokane Valley, WA 99216-3542
Phone
(509) 456-5380
Fax
(509) 456-5381
NPI assigned
Aug 23, 2005
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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 AP30004926 WA Primary
Certified Registered Nurse Anesthetist 367500000X RNA-919A ID
Registered Nurse 163W00000X RN00083645 WA

Addresses

Primary practice location

16818 E Desmet CT
Spokane Valley, WA 99216-3542

Mailing address

PO Box 1506
Chehalis, WA 98532-0409
Phone (360) 242-3008

Other practice location 1

2607 S Manito Blvd
Spokane, WA 99203-2455
Phone (509) 981-6274

Other identifiers 5

IdentifierTypeStateIssuer
1020826MedicaidWA
G8949118OtherWAMEDICARE WA
1861485021MedicaidID
35225OtherWALABOR AND INDUSTRIES
430030686OtherWARAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asc.pclispokane.p1@direct.pcli.nextgenshare.com

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RNA-919AIDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients

Locations

2517 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 748-8632

6695 W Rio Grande Ave
Kennewick, WA 99336
Phone (509) 736-0826

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1861485021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320409",
            "telephone_number": "360-242-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16818 E DESMET CT",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992163542",
            "telephone_number": "509-456-5380",
            "fax_number": "509-456-5381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2607 S Manito Blvd",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992032455",
            "country_code": "US",
            "telephone_number": "509-981-6274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONSON",
        "first_name": "DANIEL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30004926",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA-919A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00083645",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020826",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G8949118",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861485021",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "35225",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430030686",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asc.pclispokane.p1@direct.pcli.nextgenshare.com",
            "affiliation": "N",
            "address_1": "16818 E Desmet Ct",
            "city": "Spokane Valley",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992163542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.