Active NPI
Christiana J Ankiambom, CRNA
- Certified Registered Nurse Anesthetist
- Bristol, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 005978
- Practice address
- 41 Brewster Rd
Bristol, CT 06010-5141 - Phone
- (860) 585-3474
- NPI assigned
- Oct 24, 2005
- Last updated
- Feb 17, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 005978 | CT | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 07924 | OH | |
| Registered Nurse | 163W00000X | 122652 | CT | |
| Registered Nurse | 163W00000X | 362351 | NY | |
| Registered Nurse | 163W00000X | 314823 | OH |
Addresses
Primary practice location
41 Brewster Rd
Bristol, CT 06010-5141
Mailing address
PO Box 417297
Boston, MA 02241-7297
Phone (866) 623-3869
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53698 | Other | AANA | |
| 2539604 | Medicaid | OH |
Other names 1
- Christiana Juliana Carter
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122652 | CT | MD | Registered Nurse |
| 362351 | NY | MD | Registered Nurse |
| 314823 | OH | MD | Registered Nurse |
| 005978 | CT | MD | Massage Therapist |
| 07924 | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Perioperative Medical Consutants Inc | Past | Accepting new patients | |
| Outpatient Anesthesia Specialists | Past | Accepting new patients |
Locations
80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249
300 Seaside Ave
Milford, CT 06460
Phone (203) 876-4000
2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375
2 Trap Falls Rd
Ste 414
Shelton, CT 06484
Phone (203) 282-4128
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Shelton, CT
- NPI 1881636397
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Cincinnati, OH
- NPI 1891976643
-
- Anesthesiology Physician
- Fairfield, OH
- NPI 1124028162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424131200000",
"number": "1891785762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 417297",
"city": "BOSTON",
"state": "MA",
"postal_code": "022417297",
"telephone_number": "866-623-3869",
"fax_number": "302-733-0854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 BREWSTER RD",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060105141",
"telephone_number": "860-585-3474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANKIAMBOM",
"first_name": "CHRISTIANA",
"middle_name": "J",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-24",
"last_updated": "2015-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CT",
"license": "005978",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "07924",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "122652",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "362351",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "314823",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AANA",
"identifier": "53698",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2539604",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTIANA",
"last_name": "CARTER",
"middle_name": "JULIANA",
"credential": "RN, CRNA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Bristol, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.