{
"Npi": {
"NPI": "1295692283",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EPIC NURSING ANESTHESIA INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "99 ALMADEN BLVD STE 600",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN JOSE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95113-1605",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "855-621-8250",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1849 OLD BAYSHORE HWY FL 3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BURLINGAME",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94010-1215",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "650-539-6000",
"PracticeLocationAddressFaxNumber": "650-539-6001",
"EnumerationDate": "01/09/2026",
"LastUpdateDate": "01/09/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NANCE",
"AuthorizedOfficialFirstName": "ETHNE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "COO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "253-777-9855",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}