Individual provider Active NPI

Alicia R Blankendaal, CRNA

  • Certified Registered Nurse Anesthetist
  • Nashville, TN
National Provider Identifier
1033449210
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
14553 Issued in TN
Practice address
110 29TH Ave N
Ste 202
Nashville, TN 37203-1401
Phone
(615) 327-4304
Fax
(615) 327-7940
NPI assigned
Jan 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 14553 TN Primary

Addresses

Primary practice location

110 29TH Ave N
Ste 202
Nashville, TN 37203-1401

Mailing address

110 29TH Ave N
Ste 202
Nashville, TN 37203-1401
Phone (615) 327-4304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160127001134 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062549553 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Practice addresses (Care Compare)

1000 Breckenridge St
Suite 100
Owensboro, KY 42303-0840
Phone (888) 851-4642

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2023 Accepting new patients
Northstar Anesthesia of Kentucky, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 18, 2016 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
Ad of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 17, 2025 Accepting new patients

Locations

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

225 Abraham Flexner Way
Ste 700
Louisville, KY 40202
Phone (502) 562-0398

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

1000 Breckenridge St
Ste 100
Owensboro, KY 42303
Phone (270) 683-2751

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1033449210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 29TH AVE N",
            "address_2": "STE 202",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031401",
            "telephone_number": "615-327-4304",
            "fax_number": "615-327-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 29TH AVE N",
            "address_2": "STE 202",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031401",
            "telephone_number": "615-327-4304",
            "fax_number": "615-327-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENDAAL",
        "first_name": "ALICIA",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "14553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.