Great Lakes Anesthesia LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

GREAT LAKES ANESTHESIA LLC

Practice address

13601 Preston Rd
1000W
Dallas, TX 75240-4911

Phone

(972) 715-5000

NPI assigned

Dec 14, 2010

Organization subpart

No

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

Authorized official

Name

Douglas Webster, DONPI 1932157286

Title

Owner

Phone

(972) 715-5000

Specialties & licenses 5

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas P. Webster, D.O.

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1932157286
  NPD (past) Authorized official

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321920000000",
    "number": "1972806925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13601 PRESTON RD",
            "address_2": "1000W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404911",
            "telephone_number": "972-715-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13601 PRESTON RD",
            "address_2": "1000W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404911",
            "telephone_number": "972-715-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2011-11-22",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-715-5000",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972806925",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Ann Grayson, MED
• Imari Zaire Grayson
• Jose Grazette
• Todd Grazia, MD
• Rubby Grbic, MD, PA
• Greater Dallas Anesthesia Partners PLLC
• Greater Dallas EMS
• Greater Dallas EMS, LTD
• Greater Dallas Healthcare Enterprises
• Greater Dallas Healthcare Enterprises

• Anesthesiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.