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FAIRLAWN SURGERY CENTER LLC
NPI 1174067912
Nurse Anesthetist, Certified Registered in Roanoke, VA

Active since December 13, 2016CLIA 49D2011410 · Accreditation
2030 STEPHENSON AVE SW, ROANOKE, VA 24014(540) 904-6170 Get Directions Write a Review

NPPES record last updated: December 13, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fairlawn Surgery Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRLAWN SURGERY CENTER LLC (NPI 1174067912) is a healthcare organization registered as a nurse anesthetist, certified registered in Roanoke, Virginia and active in the NPI registry since December 2016. The organization holds an CLIA Accreditation certificate valid through July 27, 2027 and lists Ryan Evans, President, as its authorized official.

NPPES Registry Identity

NPI1174067912
Entity TypeOrganization
Primary Taxonomy367500000X
Legal Business NameFAIRLAWN SURGERY CENTER LLC
Location Address2030 STEPHENSON AVE SWRoanoke, VA 24014-1664
Mailing Address2030 Stephenson Ave SwRoanoke, VA 24014-1664 · (540) 904-6170
Phone(540) 904-6170
Organization SubpartNo
Authorized OfficialRyan EvansPresident · (412) 418-6077
Enumeration DateDecember 13, 2016
✔ NPI 1174067912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
Definition
(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.
Also ListedAnesthesiologyTaxonomy 207L00000X
2030 STEPHENSON AVE SW, Roanoke, VA 24014
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 49D2011410

Fairlawn Surgery Center, LLC · Roanoke, VA
Active · expires Jul 27, 2027
CLIA Number49D2011410
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJuly 28, 2025
Certificate Expiration DateJuly 27, 2027
Laboratory DirectorDr. Ryan D. Evans
Laboratory Phone(540) 904-6170
Laboratory LocationFairlawn Surgery Center, LLC2030 Stephenson Avenue, Roanoke, VA 24014
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ROBERT BRADEN DUNMIRE III MD
Internal Medicine (Nephrology)
2030 STEPHENSON AVE SW
ROANOKE, VA 24014
Roanoke City (540) 904-6170
FSC ANESTHESIA LLC
Nurse Anesthetist, Certified Registered
2030 STEPHENSON AVE SW
ROANOKE, VA 24014
Roanoke City (540) 283-7244
DR. RYAN DALE EVANS MD
Internal Medicine (Nephrology)
2030 STEPHENSON AVE SW
ROANOKE, VA 24014
Roanoke City (540) 904-6170
FAIRLAWN SURGERY CENTER, LLC
Clinic/Center (Ambulatory Surgical)
2030 STEPHENSON AVE SW
ROANOKE, VA 24014
Roanoke City (540) 904-6170

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fairlawn Surgery Center LLC's NPI number?

The NPI number for Fairlawn Surgery Center LLC is 1174067912. It was assigned to this organization in the NPPES registry on December 13, 2016.

Where is Fairlawn Surgery Center LLC located?

Fairlawn Surgery Center LLC is located at 2030 Stephenson Ave SW, Roanoke, VA 24014. The listed phone number is (540) 904-6170.

What is Fairlawn Surgery Center LLC's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Does Fairlawn Surgery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 49D2011410) is associated with this NPI, valid through July 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fairlawn Surgery Center LLC was last updated on December 13, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.