Carly Provan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN9514153 Issued in FL

Practice address

8000 State Road 64 E
Bradenton, FL 34212-7703

Phone

(941) 792-1404

NPI assigned

Mar 14, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capital Anesthesia Solutions of Florida II, LLC 327 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Blake Hospital Hospital, Bradenton, FL, CCN 100213

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Capital Anesthesia Solutions of Florida II, LLC

  • Anesthesiology Physician
  • Naples, FL
  • NPI 1891318481

  FL

  Medicare reassignment Care Compare group NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Fleming Island Anesthesia LLC

  • Anesthesiology Physician
  • Orange Park, FL
  • NPI 1487945895

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HCA Health Services of Florida, Inc.

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1114964244

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1003675992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12912 USF HEALTH DRIVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 STATE ROAD 64 E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342127703",
            "telephone_number": "941-792-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVAN",
        "first_name": "CARLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "RN9514153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Private Psychiatry of South West Florida. Inc
• Richard A Proctor, D.O., PHARM.D.,
• Prof/Guidewell Sanitas Med CNT
• Christine Profito, PSY.D.
• Thomas L. Prosser, P.A.
• Providia Home Care LLC.
• Regina D Pruitt, PA-C
• Publix Pharmacy
• Publix Super Markets Inc
• Publix Super Markets Inc

• All providers in Bradenton, FL
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.