NPIMap

Organization Active NPI

Ottawa Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Ottawa, KS
National Provider Identifier
1952372450
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
OTTAWA ANESTHESIA LLC
Practice address
1301 South Main
Ottawa, KS 66067
Phone
(785) 229-8200
NPI assigned
Feb 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2008

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

Authorized official

Name
Milton Laverne Sampson, CRNANPI 1659341634
Title
Member
Phone
(785) 229-8200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1301 South Main
Ottawa, KS 66067

Mailing address

PO Box 388
Newton, KS 67114-0388
Phone (316) 281-3700

Other identifiers 2

IdentifierTypeStateIssuer
111174OtherKSBCBS
200331170AMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050812000461 KS Part B Supplier - Clinic/Group Practice 9032149737 Receives reassigned benefits from 13 practitioners
Practice locations: Ottawa, KS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219276800000",
    "number": "1952372450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671140388",
            "telephone_number": "316-281-3700",
            "fax_number": "316-282-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SOUTH MAIN",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "66067",
            "telephone_number": "785-229-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTAWA ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2008-08-21",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "MILTON",
        "authorized_official_middle_name": "LAVERNE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "785-229-8200",
        "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "111174",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200331170A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; 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.

Verify at the official NPI Registry.