Individual provider Active NPI

Paul Nissley, CRNA

  • Certified Registered Nurse Anesthetist
  • Richmond, VA
National Provider Identifier
1962548065
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0001088658 Issued in VA
Practice address
1602 Skipwith Rd
Richmond, VA 23229-5205
Phone
(804) 289-4937
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 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 0001088658 VA Primary

Addresses

Primary practice location

1602 Skipwith Rd
Richmond, VA 23229-5205

Mailing address

1504 Santa Rosa Rd
Suite 206
Richmond, VA 23229-5109
Phone (804) 288-4453

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
0001088658VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Ambulatory Anesthesia, Inc Past Accepting new patients
Anesthesia Associates of Richmond, Inc Past Accepting new patients
Hanover Anesthesia Group,Inc Past Accepting new patients
American Anesthesiology Associates of Virginia, Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1962548065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 SANTA ROSA RD",
            "address_2": "SUITE 206",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232295109",
            "telephone_number": "804-288-4453",
            "fax_number": "804-288-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 SKIPWITH RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232295205",
            "telephone_number": "804-289-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSLEY",
        "first_name": "PAUL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001088658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

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