TONY O SANDSTROM (NPI# 1780670034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780670034 |
| Entity Type | Individual |
| Full Name | TONY O SANDSTROM |
| Credential | CRNA |
| Practice Address |
309 N Bartlett St Shawano WI 54166-2127 |
| Mailing Address |
4401 Masthead St Ne Suite 120 Albuquerque NM 87109-4497 |
| Practice Telephone | 7155262111 |
| Practice Fax Number | 7155269166 |
| Mailing Telephone | 5052437729 |
| Mailing Fax Number | 5052434804 |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2015-11-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | RN126117 | TN | Allopathic & Osteopathic Physicians |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 5845 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | MEDICARE PTAN | K400174628 | 01 |
| WI | MEDICARE PTAN | K400170079 | 01 |
| Street Address |
309 N BARTLETT ST |
| City | SHAWANO |
| State | WI |
| Zip Code | 54166-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609877505 | Robert R Eastman | Family Medicine | 309 N Bartlett St, Shawano, WI 54166-2127 | 2005-08-02 |
| 1336525526 | Elle Kosciuk | Specialist/Technologist | 309 N Bartlett St, Shawano, WI 54166-2127 | 2015-08-11 |
| 1952684607 | Sharisa M Ruh | Physician Assistant | 309 N Bartlett St, Shawano, WI 54166-2127 | 2011-09-20 |
| 1508155474 | Forefront Dermatology, S.c. | Dermatology | 309 N Bartlett St, Shawano, WI 54166 | 2011-03-31 |
| 1265731590 | Paul Michael Theuerkauf | Physical Therapist | 309 N Bartlett St, Shawano, WI 54166-2127 | 2011-03-25 |
| 1942430996 | Sheila M Landon | Nurse Practitioner | 309 N Bartlett St, Shawano, WI 54166-2127 | 2009-07-23 |
| 1669563763 | Scott A Hathaway | Emergency Medicine | 309 N Bartlett St, Shawano, WI 54166-2127 | 2006-09-27 |
| 1639279383 | Rajeshwar Hanmiah | Emergency Medicine | 309 N Bartlett St, Shawano, WI 54166-2127 | 2006-09-23 |
| 1598863334 | George E Vidalakis | Emergency Medicine | 309 N Bartlett St, Shawano, WI 54166-2127 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134641848 | Nicole Jeannine Klotzbuecher | Optometrist | 150 County Road B, Shawano, WI 54166 | 2017-07-13 |
| 1437605714 | Jennifer Marie Franke | Counselor | 504 Lakeland St, Shawano, WI 54166 | 2016-08-28 |
| 1699017913 | Benjamin D Schlais | Family Medicine | 100 County Hwy B, Shawano, WI 54166 | 2013-03-25 |
| 1154574366 | Luke T Johnson | Speech-Language Pathologist | N3684 River Road, Shawano, WI 54166 | 2008-10-31 |
| 1902054315 | Robert Joseph Bohr Jr. | Physical Therapy Assistant | N6590 Fox Lane, Shawano, WI 54166 | 2008-08-28 |
| 1790945863 | Patricia Rae Ainsworth | Physical Therapist | 1436 South Lincoln Street, Shawano, WI 54166 | 2008-06-12 |
| 1649491820 | Shawano-gresham School District | Local Education Agency (LEA) | 1050 South Union Street, Shawano, WI 54166 | 2007-05-02 |
| 1114043387 | Thomas G Peterson | Optometrist | 150a County Road B, Shawano, WI 54166 | 2007-03-21 |
| 1740343086 | John Milton Dovorany | Dentist | 1488 E Green Bay St, Shawano, WI 54166 | 2006-12-18 |
| 1265526305 | Charles E Lamarche | Counselor | 420 E Green Bay St, Ste 201, Shawano, WI 54166 | 2006-10-03 |
| Find all providers in zip 54166 | ||||
| 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 |
|---|---|---|---|---|
| 1194267088 | Cortny A Rector | Nurse Anesthetist, Certified Registered | 100 County Road B, Shawano, WI 54166-7072 | 2016-11-09 |
| 1720098197 | Ty D Thornock | Nurse Anesthetist, Certified Registered | 100 County Road B, Shawano, WI 54166-7072 | 2006-08-09 |
| 1467462838 | John E Schreiner | Nurse Anesthetist, Certified Registered | 100 County Road B, Shawano, WI 54166-7072 | 2006-08-09 |
| 1891705364 | John D Scharine | Nurse Anesthetist, Certified Registered | 100 County Road B, Shawano, WI 54166-7072 | 2006-08-08 |
| 1689622979 | Thomas L Olmsted | Nurse Anesthetist, Certified Registered | 100 County Road B, Shawano, WI 54166-7072 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943637 | Michael Poeschel | Nurse Anesthetist, Certified Registered | 2109 E Capitol Dr Ste B, Appleton, WI 54911-8726 | 2020-05-07 |
| 1285148643 | River Valley Anesthesia, Inc. | Nurse Anesthetist, Certified Registered | 130 S. Knowles Ave., New Richmond, WI 54017 | 2017-11-21 |
| 1295278356 | Braden Williams | Nurse Anesthetist, Certified Registered | 955 Pheasant Creek Dr, Oshkosh, WI 54904 | 2016-11-22 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1053790972 | Rest Assured Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 1200 John Q Hammons Dr Ste 102, Madison, WI 53717-1967 | 2015-05-26 |
| 1205223898 | Petagaye Tm Johnson | Nurse Anesthetist, Certified Registered | 5150 E Cheryl Pkwy Unit 301, Fitchburg, WI 53711-7659 | 2015-04-21 |
| 1568851194 | Nicholas Joseph Nuccio | Nurse Anesthetist, Certified Registered | 720 S Marquette St, #302, Racine, WI 53403-1174 | 2015-01-20 |
| 1285030452 | Garner Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 254 E Marquette St, Berlin, WI 54923-1298 | 2014-11-14 |
| 1073934048 | Lynne M Krebs Crna Sc | Nurse Anesthetist, Certified Registered | W178n9912 Rivercrest Dr Ste 102, Germantown, WI 53022-4645 | 2013-12-18 |
| 1831537679 | Roxanne Brault | Nurse Anesthetist, Certified Registered | 7929 S 66th St, Franklin, WI 53132-9281 | 2013-06-13 |
| Find all providers with the same taxonomy | ||||
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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.