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MEMORIAL HOSPITAL POLK COUNTY NPI 1215984687


NPI Information

NPI: 1215984687
Provider Name: MEMORIAL HOSPITAL POLK COUNTY

Doing Business As: ANESTHESIA GROUP

Classification: Nurse Anesthetist, Certified Registered - 367500000X
Entity Type: Organization
Address:
1717 HIGHWAY 59 LOOP N
LIVINGSTON, TX
ZIP 77351
Phone: (936) 631-3474
Get Directions

MEMORIAL HOSPITAL POLK COUNTY is a nurse anesthetist certified registered in Livingston, TX. 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. MEMORIAL HOSPITAL POLK COUNTY NPI is 1215984687. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Anesthesia Group.

The provider's business location address is:

1717 HIGHWAY 59 LOOP N
LIVINGSTON, TX
ZIP 77351-703
Phone: (936) 631-3474
Fax: (936) 631-3475

The provider's authorized official is Fonda R Sullivan .
The authorized official title is Insurance Supervisor and has the following contact phone number (936) 631-3474.

The enumeration date for this NPI number is 5/30/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
1367500000XNurse Anesthetist, Certified Registered237108TEXASYes
2367500000XNurse Anesthetist, Certified Registered452164TEXASX
3367500000XNurse Anesthetist, Certified Registered656746TEXASX
4367500000XNurse Anesthetist, Certified Registered422854TEXASX
5367500000XNurse Anesthetist, Certified Registered033599TEXASX
6367500000XNurse Anesthetist, Certified Registered041553TEXASX
7367500000XNurse Anesthetist, Certified Registered048803TEXASX
8174400000XSpecialistL6696TEXASX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1080663002MEDICAIDTEXAS
200479NOTHERTEXASBLUE CROSS GRP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.