NPIMap

Organization Active NPI

Anesthesia Critical Care Nursing,PA

  • Medical-Surgical Registered Nurse
  • Dodge City, KS
National Provider Identifier
1881611713
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
Legal business name
ANESTHESIA CRITICAL CARE NURSING,PA
Practice address
2203 Summerlon Cir
Dodge City, KS 67801-2985
Phone
(620) 408-9454
Fax
(620) 408-9552
NPI assigned
Jul 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Terry Martin, CRNANPI 1639178874
Title
Owner
Phone
(620) 225-2847

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X NU Primary

Addresses

Primary practice location

2203 Summerlon Cir
Dodge City, KS 67801-2985

Mailing address

100 W Ross Blvd Ste B
Dodge City, KS 67801-7216
Phone (620) 225-2847

Other identifiers 1

IdentifierTypeStateIssuer
9159799201MedicaidKS

National Provider Directory

National Provider Directory

Locations

100 W Ross Blvd
Dodge City, KS 67801
Phone (316) 225-2847

100 W Ross Blvd
Ste B
Dodge City, KS 67801

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881611713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W ROSS BLVD STE B",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678017216",
            "telephone_number": "620-225-2847",
            "fax_number": "620-225-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 SUMMERLON CIR",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012985",
            "telephone_number": "620-408-9454",
            "fax_number": "620-408-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA CRITICAL CARE NURSING,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "620-225-2847",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9159799201",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.