Individual provider Active NPI

Eric Jacob Lindstrom, CRNA

  • Certified Registered Nurse Anesthetist
  • Morgantown, WV
National Provider Identifier
1891975710
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
69067 Issued in WV
Practice address
101 Stadium Dr
Morgantown, WV 26506-7911
Phone
(304) 598-4000
Fax
(304) 293-6963
NPI assigned
Nov 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 69067 WV Primary

Addresses

Primary practice location

101 Stadium Dr
Morgantown, WV 26506-7911

Mailing address

PO Box 897
Morgantown, WV 26507-0897
Phone (304) 293-7401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080331000207 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860578960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Virginia University Medical CorporationGroup PAC ID 1052224565, 1,974 clinicians

Practice addresses (Care Compare)

930 Chestnut Ridge Rd
Morgantown, WV 26505-2854
Phone (304) 293-5299

Hospital & facility affiliations

  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
69067WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation Current Accepting new patients
Wvu Medical Corporation CurrentSince Jan 26, 2008 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jan 26, 2008 Accepting new patients
Latrobe Anesthesia Associates, Inc Past Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

930 Chestnut Ridge Rd
Morgantown, WV 26505
Phone (304) 293-5299

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1891975710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070897",
            "telephone_number": "304-293-7401",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 STADIUM DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265067911",
            "telephone_number": "304-598-4000",
            "fax_number": "304-293-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSTROM",
        "first_name": "ERIC",
        "middle_name": "JACOB",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "69067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.