Foxtrot Anesthesia

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

FOXTROT ANESTHESIA

Practice address

933 Sell Ave
Canon City, CO 81212-4929

Phone

(719) 275-6433

Fax

(952) 442-3620

NPI assigned

Apr 19, 2022

Organization subpart

No

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

Authorized official

Name

Kevin S Diamond, CRNA

Title

President

Phone

(719) 418-1264

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1932842606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 10TH ST E",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-3644",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 SELL AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124929",
            "telephone_number": "719-275-6433",
            "fax_number": "952-442-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOXTROT ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-418-1264",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Canon City, CO
• Providers in Canon City, CO by specialty
• Certified Registered Nurse Anesthetist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.