Active NPI
Keith S Ewer, CRNA
- Certified Registered Nurse Anesthetist
- Cabot, AR
National Provider Identifier
1104916113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- C00270
- Practice address
- 474 Southwood Cir
Cabot, AR 72023-8917 - Phone
- (501) 843-5858
- NPI assigned
- Oct 13, 2006
- Last updated
- Jul 19, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | C00270 | AR | Primary |
Addresses
Primary practice location
474 Southwood Cir
Cabot, AR 72023-8917
Mailing address
474 Southwood Circle
Cabot, AR 72023-8917
Phone (501) 843-5858
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121464701 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C00270 | AR | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dyersburg Hospital Company LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Anesthesiology Services LTD | Past | Accepting new patients | |
| Anesthesia Partners PLLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Conway Anesthesiology Consultants, P.a. | Past | Accepting new patients | |
| Anesthesia and Pain Management Assoc., P.a. | Past | Accepting new patients | |
| Rebsamen Anesthesia Inc | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Kennebec Anesthesia Associates, P.a. | Past | Accepting new patients |
Organizations & group practices 7
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.
-
- Anesthesiology Physician
- Searcy, AR
- NPI 1689621245
-
- Anesthesiology Physician
- North Little Rock, AR
- NPI 1184687881
-
- Anesthesiology Physician
- Conway, AR
- NPI 1568423820
-
- Anesthesiology Physician
- Jacksonville, AR
- NPI 1972671907
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Dyersburg, TN
- NPI 1396720439
Nurse Anesthetist, Certified Registered
-
dba Dyersburg Hospital Anesthesia
- Anesthesiology Physician
- Dyersburg, TN
- NPI 1164471413
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Augusta, ME
- NPI 1992789184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311033600000",
"number": "1104916113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "474 SOUTHWOOD CIRCLE",
"city": "CABOT",
"state": "AR",
"postal_code": "720238917",
"telephone_number": "501-843-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "474 SOUTHWOOD CIR",
"city": "CABOT",
"state": "AR",
"postal_code": "720238917",
"telephone_number": "501-843-5858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EWER",
"first_name": "KEITH",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2011-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AR",
"license": "C00270",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121464701",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cabot, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.