Levi Colter Black, CRNA | |
117 E 19th St, Roswell, NM 88201-5151 | |
(814) 877-2137 | |
Not Available |
Full Name | Levi Colter Black |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 11 Years |
Location | 117 E 19th St, Roswell, New Mexico |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508185760 | NPI | - | NPPES |
528136 | Medicaid | AZ | |
1508185760 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | CRNA0680 (Arizona) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Summit Healthcare Regional Medical Center | Show low, AZ | Hospital |
Lovelace Regional Hospital - Roswell | Roswell, NM | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Northeastern Anesthesia Pllc | 4284813940 | 20 |
Main Street Anesthesia Of New Mexico, Llc | 3476807538 | 149 |
Entity Name | Northeastern Anesthesia Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487956504 PECOS PAC ID: 4284813940 Enrollment ID: O20110126001051 |
Mailing Address | Practice Location Address |
---|---|
Levi Colter Black, CRNA 530b Harkle Rd Ste 100, Santa Fe, NM 87505-4739 Ph: (480) 254-1430 | Levi Colter Black, CRNA 117 E 19th St, Roswell, NM 88201-5151 Ph: (814) 877-2137 |
Mr. Mark David Murley, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 117 E 19th St, Roswell, NM 88201 Phone: 575-624-2095 | |
Michael S Berg, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 405 W Country Club Rd, Roswell, NM 88201 Phone: 505-622-8170 Fax: 505-624-8711 | |
Christopher Mathew Lynn, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 405 W Country Club Rd, Roswell, NM 88201 Phone: 575-622-8170 | |
Stefania Rok, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 405 W Country Club Rd, Roswell, NM 88201 Phone: 575-622-8170 | |
Sheila M Fitzgerald, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 405 W Country Club Rd, Roswell, NM 88201 Phone: 575-622-8170 | |
Joy Lee Lindgren, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 405 W Country Club Rd, Roswell, NM 88201 Phone: 505-622-8170 Fax: 505-624-8711 | |
James Oliver Jones Jr., CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 113 East 19th, Roswell, NM 88201 Phone: 505-627-7000 Fax: 505-627-7007 |