Active NPI
Chance Green, CRNA
- Certified Registered Nurse Anesthetist
- Lakeside, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 28162181
- Practice address
- 5448 Highway 260 Ste 100
Lakeside, AZ 85929-5736 - Phone
- (928) 359-1862
- Fax
- (928) 537-2049
- NPI assigned
- Jun 22, 2006
- Last updated
- Mar 19, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 28162181 | IN | Primary |
Addresses
Primary practice location
5448 Highway 260 Ste 100
Lakeside, AZ 85929-5736
Mailing address
135 N Center St Unit 5870
Mesa, AZ 85211-7159
Phone (480) 874-7014
Other practice location 1
200 W Hospital Dr
Whiteriver, AZ 85941-0860
Phone (928) 338-4911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200513510 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5448 S White Mountain Blvd
Suite 100
Lakeside, AZ 85929-5739
Phone (928) 532-3010
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fancy Anesthesia Services Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Northeastern Anesthesia PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Cardinal Anesthesia, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Antigua Anesthesia Management, LLC | Current | Accepting new patients | |
| MB Anesthesiology LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Northern Indiana Anesthesia Services, P.C. | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Anesthesia Associates of Savannah ,PA | Past | Accepting new patients |
Locations
5448 Highway 260
Ste 100
Lakeside, AZ 85929
Phone (283) 581-8629
2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375
Organizations & group practices 7
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.
-
- Certified Registered Nurse Anesthetist
- Show Low, AZ
- NPI 1003055914
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Bullhead City, AZ
- NPI 1912502055
-
- Anesthesiology Physician
- Sierra Vista, AZ
- NPI 1487956504
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Lakeside, AZ
- NPI 1861700957
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Mesa, AZ
- NPI 1003640442
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Savannah, GA
- NPI 1487663688
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1083639660
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773878400000",
"number": "1962448480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 N CENTER ST UNIT 5870",
"city": "MESA",
"state": "AZ",
"postal_code": "852117159",
"telephone_number": "480-874-7014",
"fax_number": "480-874-7015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5448 HIGHWAY 260 STE 100",
"city": "LAKESIDE",
"state": "AZ",
"postal_code": "859295736",
"telephone_number": "928-359-1862",
"fax_number": "928-537-2049"
}
],
"practiceLocations": [
{
"address_1": "200 W HOSPITAL DR",
"address_purpose": "LOCATION",
"city": "WHITERIVER",
"state": "AZ",
"postal_code": "859410860",
"country_code": "US",
"telephone_number": "928-338-4911",
"fax_number": "928-338-3522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "CHANCE",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2026-03-19",
"certification_date": "2026-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IN",
"license": "28162181",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200513510",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakeside, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; 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.