Michael George Theele, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1059523 Issued in KY

Practice address

723 Burkesville Hwy
Albany, KY 42602-1654

Phone

(865) 777-0909

Fax

(865) 777-0910

NPI assigned

Nov 10, 2005

Last updated

Jan 11, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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

• Commonwealth Anesthesia, PSC

  • Anesthesiology Physician
  • Lexington, KY
  • NPI 1437196300

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Resource Anesthesia Lakeway, Inc.

  • Specialist
  • Lenoir, NC
  • NPI 1144573015
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1083695522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12752 KINGSTON PIKE",
            "address_2": "STE E202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379340948",
            "telephone_number": "865-777-0909",
            "fax_number": "865-777-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 BURKESVILLE HWY",
            "city": "ALBANY",
            "state": "KY",
            "postal_code": "426021654",
            "telephone_number": "865-777-0909",
            "fax_number": "865-777-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEELE",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1059523",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1102A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "10643",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000350186",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00408377",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74110214",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tallent Cosmetic and Family Dentistry
• Tammy L. Brown, M.D., P.S.C.
• Thomas Alvis Thacker, DO
• The Medical Center at Clinton County, Inc. (Med Center MRI)
• The Medical Center at Clinton County, Inc. (Med Center Health Family Care Albany)
• Miranda Tompkins
• Twin Lakes MRI,LLC
• Gary Walter Upchurch, OD
• Vision Care of Albany Inc.
• Keylee Stalcup Watson, PT, DPT

• Certified Registered Nurse Anesthetist in Albany, KY
• Providers in Albany, KY by specialty
• Certified Registered Nurse Anesthetist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.