Individual provider Active NPI

Amber Jean Callison, CRNA

  • Certified Registered Nurse Anesthetist
  • Newport News, VA
National Provider Identifier
1912367616
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024173334 Issued in VA
Practice address
500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone
(757) 594-2000
NPI assigned
Feb 24, 2016
Last updated
Feb 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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 0024173334 VA Primary

Addresses

Primary practice location

500 J Clyde Morris Blvd
Newport News, VA 23601-1929

Mailing address

416 Minute Men Rd
Virginia Beach, VA 23462-2230
Phone (419) 957-9213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, AL, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160404001730 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850698960
I20171103002324 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850698960 Reassigns benefits to 3 organizations
I20190424002652 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850698960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Ohio State University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Norman Anesthesia AssociatesGroup PAC ID 1951396126, 25 clinicians

Practice addresses (Care Compare)

114 Commerce Ctr Loop
Suite B
Mooresville, NC 28117-8385
Phone (704) 662-0877

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024173334VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan Anesthesiology Associates PC CurrentSince Dec 13, 2017 Accepting new patients
Lake Norman Anesthesia Associates CurrentSince Mar 1, 2019 Accepting new patients
Epix Anesthesia of Alabama LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 28, 2018 Accepting new patients
Veronox Anesthesia, LLC CurrentSince Nov 21, 2018 Accepting new patients

Locations

400 E 10th St
Anniston, AL 36207
Phone (256) 235-5121

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

201 E Watts St
Enterprise, AL 36330
Phone (334) 383-5474

400 N Edwards St
Enterprise, AL 36330
Phone (334) 347-0584

200 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-3150

114 Commerce Center Loop
Ste B
Mooresville, NC 28117
Phone (704) 662-0877

146 Medical Park Rd
Ste 108
Mooresville, NC 28117
Phone (704) 662-0876

171 Fairview Rd
Mooresville, NC 28117
Phone (704) 660-4000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1912367616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 MINUTE MEN RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622230",
            "telephone_number": "419-957-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-594-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLISON",
        "first_name": "AMBER",
        "middle_name": "JEAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024173334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.