Individual provider Active NPI

Adam Shane David, CRNA

  • Certified Registered Nurse Anesthetist
  • Murray, KY
National Provider Identifier
1083931034
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3006454 Issued in KY
Practice address
632 N 12TH St # 230
Murray, KY 42071-1651
Phone
(859) 948-8389
NPI assigned
Apr 30, 2010
Last updated
Dec 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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 3006454 KY Primary

Addresses

Primary practice location

632 N 12TH St # 230
Murray, KY 42071-1651

Mailing address

632 N 12TH St # 230
Murray, KY 42071-1651
Phone (859) 948-8389

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927000881 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234255365 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apex Anesthesia Partners PLLCGroup PAC ID 3476891656, 34 clinicians

Practice addresses (Care Compare)

2501 Kentucky Ave
Paducah, KY 42003-3813
Phone (270) 575-2100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3006454KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Murray Anesthetists Group, PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2011 Accepting new patients
Northstar Anesthesia of Kentucky, PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2016 Accepting new patients
Apex Anesthesia Partners, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2019 Accepting new patients
Murray Anesthesia Group, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Marshall County Anesthesia Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

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

632 N 12th St
Murray, KY 42071
Phone (270) 210-8873

803 Poplar St
Murray, KY 42071
Phone (270) 762-1155

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

2501 Kentucky Ave
Paducah, KY 42003
Phone (270) 575-2180

Organizations & group practices 5

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.

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": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1083931034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 N 12TH ST # 230",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420711651",
            "telephone_number": "859-948-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 N 12TH ST # 230",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420711651",
            "telephone_number": "859-948-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "ADAM",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-30",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3006454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.