RENEE ANDERSON, CRNA - NPI NUMBER 1457339848

Summary

Provider Name: RENEE ANDERSON, CRNA

NPI Number: 1457339848

Clasification: Nurse Anesthetist, Certified Registered (367500000X)

Organization: SAN MIGUEL HOSPITAL CORPORATION

Address:
1801 16TH ST
GREELEY, CO
ZIP 80631

Phone Number: (970) 350-6399



Detailed Information

Renee Anderson, CRNA is a nurse anesthetist, certified registered in Greeley, CO with 41 years of experience. The provider is (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. The assigned NPI number for this provider is 1457339848 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF COLORADO SCHOOL OF MEDICINE
Graduation Year: 1974

The provider's business address is:

1801 16TH ST
GREELEY, CO
ZIP 80631-154
Phone: (970) 350-6399
Fax: (970) 378-4687

The enumeration date for this NPI number is 1/5/2006 and was last updated on 12/15/2009.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 367500000X Nurse Anesthetist, Certified Registered R46512 NM No
2 367500000X Nurse Anesthetist, Certified Registered CRA-644 CO Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 897837 OTHER AZ AHCCCS
2 10001388 OTHER NM LOVELACE HEALTH/SALUD
3 CO41192 MEDICARE PIN CO
4 07530207 MEDICAID CO
5 E0548 MEDICAID NM
6 201033429 OTHER NM PRESBYTERIAN HEALTH/SALUD
7 NM009S64 OTHER NM BC/BS
8 PROVP11218 OTHER NM MOLINA
9 344503401 MEDICARE ID-TYPE UNSPECIFIED

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1457339848 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name ANDERSON The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name RENEE The first name of the provider, if the provider is an individual.
5 Provider Credential Text CRNA The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
6 Provider First Line Business Practice Location Address 1801 16TH ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name GREELEY The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name CO The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 806315154 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 9703506399 The telephone number associated with the location address of the provider being identified.
12 Provider Business Practice Location Address Fax Number 9703784687 The fax number associated with the location address of the provider being identified.
13 Provider Enumeration Date 1/5/2006 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 12/15/2009 The date that a record was last updated or changed.
15 Provider Gender Code F The code designating the provider’s gender if the provider is a person.
16 Healthcare Provider Taxonomy Code 1 367500000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
17 Provider License Number 1 R46512 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
18 Provider License Number State Code 1 NM The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
19 Healthcare Provider Primary Taxonomy Switch 1 N
20 Healthcare Provider Taxonomy Code 2 367500000X
21 Provider License Number 2 CRA-644 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
22 Provider License Number State Code 2 CO The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
23 Healthcare Provider Primary Taxonomy Switch 2 Y
24 Other Provider Identifier 1 897837 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
25 Other Provider Identifier Type Code 1 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
26 Other Provider Identifier State 1 AZ
27 Other Provider Identifier Issuer 1 AHCCCS
28 Other Provider Identifier 2 10001388 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
29 Other Provider Identifier Type Code 2 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier State 2 NM
31 Other Provider Identifier Issuer 2 LOVELACE HEALTH/SALUD
32 Other Provider Identifier 3 CO41192 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
33 Other Provider Identifier Type Code 3 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
34 Other Provider Identifier State 3 CO
35 Other Provider Identifier 4 07530207 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
36 Other Provider Identifier Type Code 4 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
37 Other Provider Identifier State 4 CO
38 Other Provider Identifier 5 E0548 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
39 Other Provider Identifier Type Code 5 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
40 Other Provider Identifier State 5 NM
41 Other Provider Identifier 6 201033429 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
42 Other Provider Identifier Type Code 6 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
43 Other Provider Identifier State 6 NM
44 Other Provider Identifier Issuer 6 PRESBYTERIAN HEALTH/SALUD
45 Other Provider Identifier 7 NM009S64 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
46 Other Provider Identifier Type Code 7 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
47 Other Provider Identifier State 7 NM
48 Other Provider Identifier Issuer 7 BC/BS
49 Other Provider Identifier 8 PROVP11218 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
50 Other Provider Identifier Type Code 8 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
51 Other Provider Identifier State 8 NM
52 Other Provider Identifier Issuer 8 MOLINA
53 Other Provider Identifier 9 344503401 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
54 Other Provider Identifier Type Code 9 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
55 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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