NPIMap

Organization Active NPI

Fade to Black Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • Lanham, MD
National Provider Identifier
1902379928
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
FADE TO BLACK ANESTHESIA SERVICES
Practice address
7501 Forbes Blvd Ste 103
Lanham, MD 20706-6201
Phone
(215) 500-7580
NPI assigned
Jan 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Authorized official

Name
Mr. Rajaee Black, CRNA
Title
Owner
Phone
(215) 500-7580

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

7501 Forbes Blvd Ste 103
Lanham, MD 20706-6201

Mailing address

PO Box 731
Laurel, MD 20725-0731
Phone (215) 500-7580

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1902379928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207250731",
            "telephone_number": "215-500-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 FORBES BLVD STE 103",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066201",
            "telephone_number": "215-500-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FADE TO BLACK ANESTHESIA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "RAJAEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-500-7580",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.