PORT ST LUCIE ANESTHESIA LLC (NPI# 1215441134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215441134 |
| Entity Type | Organization |
| Organization Name | PORT ST LUCIE ANESTHESIA LLC |
| Practice Address |
1715 Se Tiffany Ave Port St Lucie FL 34952-7511 |
| Mailing Address |
1a Burton Hills Blvd Nashville TN 37215-6187 |
| Practice Telephone | 7723357005 |
| Mailing Telephone | 6159226102 |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |
| Authorized Official Name | PHILLIP CLENDENIN (PRESIDENT, ASC) |
| Authorized Official Telephone | 6156651283 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1715 SE TIFFANY AVE |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34952-7511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760412456 | Delrowe Eye Care, Pa | Ophthalmology | 1715 Se Tiffany Ave, Port St Lucie, FL 34952-7520 | 2006-07-05 |
| 1326649476 | Gina Rana, Md, Pa | Clinic/Center | 1715 Se Tiffany Ave, Port St Lucie, FL 34952-7511 | 2020-11-05 |
| 1497108674 | St Lucie Optical West, Inc | Technician/Technologist | 1715 Se Tiffany Ave, Port St Lucie, FL 34952-7511 | 2016-07-22 |
| 1598184798 | Gina Rana | Psychiatry & Neurology | 1715 Se Tiffany Ave, Port St Lucie, FL 34952-7511 | 2014-04-15 |
| 1083920151 | Hillmoor Eye Surgery Center, LLC | Clinic/Center | 1715 Se Tiffany Ave, Port St Lucie, FL 34952-7520 | 2010-08-26 |
| 1710026281 | Southeast Anesthesia Associates | Nurse Anesthetist, Certified Registered | 1715 Se Tiffany Ave, Port St Lucie, FL 34952-7520 | 2007-02-05 |
| 1336165091 | Hillmoor Eye Surgery Center, Inc. | Clinic/Center | 1715 Se Tiffany Ave, Port St Lucie, FL 34952-7520 | 2006-07-14 |
| 1497780357 | Daniel J Delrowe | Ophthalmology | 1715 Se Tiffany Ave, Port St Lucie, FL 34952-7520 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215587068 | Carehere LLC | Family Medicine | Carehere Clinic- St. Lucie Psl, 1680 Se Lyngate Drive, Port St Lucie, FL 34952 | 2019-09-13 |
| 1255998274 | Morningside Alf | Assisted Living Facility | 2233 Se Mroningside Alf, Port Saint Lucie, FL 34952 | 2019-05-24 |
| 1336611870 | Med Braces and Supplies, LLC | Durable Medical Equipment & Medical Supplies | 1484 Se Village Green Dr, Port St Lucie, FL 34952 | 2018-12-21 |
| 1689143794 | The Gift of Recovery, LLC | Counselor | 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 | 2018-11-19 |
| 1457830853 | Cathy L Sonier | Counselor | 357 Brazilian Circle, Port St Lucie, FL 34952 | 2018-08-07 |
| 1548756661 | Blo 7 Diabetes Institute Inc | Nutritionist | 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 | 2018-07-02 |
| 1780194464 | Doctor's Choice Medical Center | Clinic/Center | 9164 S Us Highway 1, Port St Lucie, FL 34952 | 2017-10-06 |
| 1801305644 | Thandiwe Daley | Behavior Technician | 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 | 2017-09-25 |
| 1700309408 | Lagrand Evan Andrews | Assistant Behavior Analyst | 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 | 2017-07-25 |
| 1578085148 | Lavetta S Ivey | Behavior Technician | 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 | 2017-07-14 |
| Find all providers in zip 34952 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (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. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407894272 | James Thomas Brown Jr. | Nurse Anesthetist, Certified Registered | 880 Sw Grand Reserve Blvd, Port St Lucie, FL 34986-2339 | 2006-06-03 |
| 1659339166 | Elizabeth A Campbell | Nurse Anesthetist, Certified Registered | 1874 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5545 | 2006-05-03 |
| 1861920373 | Nikola Matson | Nurse Anesthetist, Certified Registered | 10000 Sw Innovation Way, Port St Lucie, FL 34987-2111 | 2017-05-28 |
| 1205377595 | Valant Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 10521 Sw Village Center Dr, Suite 104, Port St Lucie, FL 34987-1930 | 2017-03-20 |
| 1538586268 | Danielle Hert | Nurse Anesthetist, Certified Registered | 10000 Sw Innovation Way, Port St Lucie, FL 34987-2111 | 2014-03-19 |
| 1144665605 | Billy Arron Floyd | Nurse Anesthetist, Certified Registered | 1800 Se Tiffany Ave, Port St Lucie, FL 34952-7521 | 2013-05-09 |
| 1710026281 | Southeast Anesthesia Associates | Nurse Anesthetist, Certified Registered | 1715 Se Tiffany Ave, Port St Lucie, FL 34952-7520 | 2007-02-05 |
| 1881702074 | John T Himebaugh | Nurse Anesthetist, Certified Registered | 1800 Se Tiffany Ave, Port St Lucie, FL 34952-7521 | 2006-08-28 |
| 1992743256 | Sharon Walter | Nurse Anesthetist, Certified Registered | 1874 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5545 | 2006-06-02 |
| 1528005857 | Steven G Cooper | Nurse Anesthetist, Certified Registered | 1874 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5545 | 2006-06-02 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34952 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.