FAIRLAWN SURGERY CENTER LLC
NPI 1174067912
Nurse Anesthetist, Certified Registered in Roanoke, VA
NPI Status: Active since December 13, 2016
Contact Information
2030 STEPHENSON AVE SW
ROANOKE, VA
ZIP 24014
Phone: (540) 904-6170
- Organization
- Nurse Anesthetist, Certified Registered
- CLIA Number: 49D2011410
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 07-27-2027
About FAIRLAWN SURGERY CENTER LLC
This page provides the complete NPI Profile along with additional information for Fairlawn Surgery Center Llc, a provider established in Roanoke, Virginia operating as a Nurse Anesthetist, Certified Registered. The healthcare provider is registered in the NPI registry with number 1174067912 assigned on December 2016. The practitioner's primary taxonomy code is 367500000X. The provider is registered as an organization and their NPI record was last updated 10 years ago. Fairlawn Surgery Center Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Ryan Evans Md (President)
- NPI
- 1174067912
- Provider Name
- FAIRLAWN SURGERY CENTER LLC
- Entity Type
- Organization
- Location Address
- 2030 STEPHENSON AVE SW ROANOKE, VA 24014
- Location Phone
- (540) 904-6170
- Mailing Address
- 2030 STEPHENSON AVE SW ROANOKE, VA 24014
- Mailing Phone
- (540) 904-6170
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-13-2016
- Last Update Date
- 12-13-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Anesthetist, Certified Registered
- Taxonomy Code
- 367500000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- Taxonomy Description
- (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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 49D2011410
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- July 28, 2025
- Certificate Expiration Date
- July 27, 2027
- Laboratory Director
- DR. RYAN D. EVANS
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Fairlawn Surgery Center Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1174067912, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
ROANOKE, VA 24014
ROANOKE, VA 24014
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174067912, enumerated as an "organization" on December 13, 2016.
The provider is located at 2030 STEPHENSON AVE SW ROANOKE, VA 24014 and the phone number is (540) 904-6170.
Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
