Active NPI
Daniel Charles Simonson, C.R.N.A.
- Certified Registered Nurse Anesthetist
- Spokane Valley, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AP30004926
- 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, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020826 | Medicaid | WA | |
| G8949118 | Other | WA | MEDICARE WA |
| 1861485021 | Medicaid | ID | |
| 35225 | Other | WA | LABOR AND INDUSTRIES |
| 430030686 | Other | WA | RAILROAD MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| RNA-919A | ID | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Ambulatory Surgical Clinic/Center
- Chehalis, WA
- NPI 1487821633
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.