Individual provider Active NPI

Lynette C Murray, CRNA

  • Certified Registered Nurse Anesthetist
  • Willimantic, CT
National Provider Identifier
1992750574
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4121 Issued in CT
Practice address
1185 Main St Ste 2
Willimantic, CT 06226-2093
Phone
(860) 423-7558
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X C01339 AR
Certified Registered Nurse Anesthetist 367500000X R52311 AR
Certified Registered Nurse Anesthetist 367500000X 4121 CT Primary

Addresses

Primary practice location

1185 Main St Ste 2
Willimantic, CT 06226-2093

Mailing address

173 Shore Rd
Waterford, CT 06385-3453
Phone (870) 421-5177

Other identifiers 1

IdentifierTypeStateIssuer
R52311OtherARRN LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090828000386 CT Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032126131 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
004121CTMDSurgical Physician Assistant
R52311ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince May 19, 2023 Accepting new patients
Northeast Medical Group, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jan 30, 2022 Accepting new patients
Anesthesia Associates of Willimantic PC CurrentSince Mar 27, 2018 Accepting new patients
Murfreesboro Anesthesia Group, P.a. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

52 Hazelnut Hill Rd
Groton, CT 06340
Phone (860) 446-8265

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

37 Kennedy Dr
Ste C
Putnam, CT 06260
Phone (860) 423-7558

2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

1185 Main St
Willimantic, CT 06226
Phone (860) 423-7558

1185 Main St
Ste 2
Willimantic, CT 06226
Phone (860) 423-7558

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1992750574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 SHORE RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063853453",
            "telephone_number": "870-421-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 MAIN ST STE 2",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262093",
            "telephone_number": "860-423-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "LYNETTE",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C01339",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "R52311",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "4121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "R52311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.