Individual provider Active NPI

Suzanne Bullard, CRNA

  • Certified Registered Nurse Anesthetist
  • Marion, VA
National Provider Identifier
1962471748
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0001122983 Issued in VA
Practice address
565 Radio Hill Rd
Marion, VA 24354-6587
Phone
(276) 782-1194
NPI assigned
Mar 15, 2006
Last updated
Mar 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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 0001122983 VA Primary

Addresses

Primary practice location

565 Radio Hill Rd
Marion, VA 24354-6587

Mailing address

PO Box 916
Damascus, VA 24236-0916
Phone (276) 475-3788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001122983VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lenoir Memorial Hospital, Incorporated Past Accepting new patients
Johnston Memorial Hospital, Inc Past Accepting new patients
Lexington Medical Center Past Accepting new patients
Burlington Anesthesia PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Wellmont Physician Services Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Lenoir Memorial Hospital, Incorporated Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1962471748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 916",
            "city": "DAMASCUS",
            "state": "VA",
            "postal_code": "242360916",
            "telephone_number": "276-475-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 RADIO HILL RD",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243546587",
            "telephone_number": "276-782-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "SUZANNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001122983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.