TOBACCO ROOT ANESTHESIOLOGY, LLC (NPI# 1811918998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811918998 |
| Entity Type | Organization |
| Organization Name | TOBACCO ROOT ANESTHESIOLOGY, LLC |
| Practice Address |
7 Vandolah Rd Three Forks MT 59752-8673 |
| Mailing Address |
Po Box 1330 Three Forks MT 59752-1330 |
| Practice Telephone | 4062856588 |
| Practice Fax Number | 4062859012 |
| Mailing Telephone | 4062856588 |
| Mailing Fax Number | 4062859012 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2014-02-12 |
| Authorized Official Name | MARK E VANDOLAH (PRESIDENT) |
| Authorized Official Telephone | 4062856588 |
| Authorized Official Credential | CRNA,MAE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | RN14372 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 4308525 | 05 |
| Street Address |
7 VANDOLAH RD |
| City | THREE FORKS |
| State | MT |
| Zip Code | 59752-8673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164800454 | Three Forks School District #j24 | Local Education Agency (LEA) | 212 East Neal, Three Forks, MT 59752 | 2015-05-07 |
| 1376678037 | Three Forks Physical Therapy, Inc. | Clinic/Center | 203 S Main St., Three Forks, MT 59752 | 2007-02-22 |
| 1457320327 | Kristin Mariah Johnson | Nurse Practitioner | 16 Railway Ave., Three Forks, MT 59752 | 2006-03-14 |
| 1447811146 | Emily Uhl Rothing | Physical Therapist | 203 S Main Street, Three Forks, MT 59752 | 2019-06-24 |
| 1093297202 | Alena R Mayer | Physical Therapy Assistant | 203 S Main St., Three Forks, MT 59752 | 2018-09-04 |
| 1013307842 | Jamie Lyn Demaray | Mechanotherapist | 119 Main Street, Three Forks, MT 59752 | 2015-02-02 |
| 1366713562 | Tina Cecilie Wambeke | Mechanotherapist | 119 S. Main St., Restoration Massage Therapy, LLC, Three Forks, MT 59752 | 2012-01-19 |
| 1942238001 | Laura Lower | Counselor | 7 Railway Ave., Three Forks, MT 59752-0462 | 2006-06-29 |
| 1699139386 | Montana Oxygen LLC | Durable Medical Equipment & Medical Supplies | 627 West Jefferson, Three Forks, MT 59752-0787 | 2016-04-08 |
| 1356471213 | Chad D Russell | Dentist | 123 Main St, Suite #1, Three Forks, MT 59752-0850 | 2007-03-07 |
| Find all providers in zip 59752 | ||||
| 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 |
|---|---|---|---|---|
| 1891769600 | Mark E Vandolah | Nurse Anesthetist, Certified Registered | 7 Vandolah Road, Three Forks, MT 59752-1330 | 2006-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558733709 | M & M Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 3207 Augusta Ave, Butte, MT 59701-4405 | 2015-10-28 |
| 1316374820 | Marcus Jay Wilsey | Nurse Anesthetist, Certified Registered | 9589 Highway 2 East, Martin City, MT 59926 | 2013-09-28 |
| 1205103306 | Spectrum Anesthesia & Pain Management Services, S.c. | Nurse Anesthetist, Certified Registered | 1739 Spring Creek Lane Suite 100, Billings, MT 59102 | 2011-11-18 |
| 1750601423 | Tana M Taylor | Nurse Anesthetist, Certified Registered | 2111 Garfield St, Anaconda, MT 59711-1719 | 2010-06-04 |
| 1194907543 | Tara Munroe | Nurse Anesthetist, Certified Registered | 925 Highland Blvd Ste 1180, Bozeman, MT 59715-6905 | 2007-11-28 |
| 1922147693 | William Mark Higgs | Nurse Anesthetist, Certified Registered | 430 Fleshman Creek Rd, Livingston, MT 59047-1536 | 2007-02-06 |
| 1437266632 | Mark Alan Edwards | Nurse Anesthetist, Certified Registered | 350 Louisiana Ave, Libby, MT 59923-2130 | 2006-08-24 |
| 1710903554 | Daniel Richard Mattson | Nurse Anesthetist, Certified Registered | 3111 Avenue E, Billings, MT 59102-6548 | 2006-07-14 |
| 1396778569 | Grant Palm | Nurse Anesthetist, Certified Registered | 320 Alpenglow Lane, Livingston, MT 59047 | 2006-07-09 |
| 1750313847 | Todd Armstrong Armstrong | Nurse Anesthetist, Certified Registered | 512 N Center Ave, Miles City, MT 59301-2602 | 2006-07-07 |
| Find all providers with the same taxonomy | ||||
| City | THREE FORKS |
| Zip Code | 59752 |
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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.