Individual provider Active NPI

Ryan Kelley

  • Certified Registered Nurse Anesthetist
  • Birmingham, AL
National Provider Identifier
1114266434
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-125488 Issued in AL
Practice address
1717 6TH Ave S
Birmingham, AL 35233-1801
Phone
(800) 822-8816
NPI assigned
Feb 6, 2013
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 1-125488 AL Primary

Addresses

Primary practice location

1717 6TH Ave S
Birmingham, AL 35233-1801

Mailing address

1717 6TH Ave S
Birmingham, AL 35233-1801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130325000252 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264677137 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cullman Regional Anesthesia Services LLCGroup PAC ID 2466785712, 34 clinicians

Practice addresses (Care Compare)

1912 Al Hwy 157
Cullman, AL 35058-0609
Phone (256) 737-2496

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-125488ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Jun 1, 2017 Accepting new patients
University of Alabama at Birmingham Current Accepting new patients
Cullman Regional Pain Services LLC CurrentSince Jun 1, 2024 Accepting new patients
University of Alabama at Birmingham Nurse Anesthetist, Certified Registered CurrentSince Jan 14, 2013 Accepting new patients
University of Alabama at Birmingham CurrentSince Jan 14, 2013 Accepting new patients
Cullman Regional Anesthesia Services LLC CurrentSince Sep 27, 2021 Accepting new patients

Locations

1717 6th Ave S
Birmingham, AL 35233
Phone (205) 934-3450

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

619 19th St S
Rm JT845
Birmingham, AL 35249
Phone (205) 934-7072

1403 Wall St
Cullman, AL 35055
Phone (256) 734-9472

1912 AL Highway 157
Cullman, AL 35058
Phone (256) 737-2496

1912 AL Highway 157
Ste 100
Cullman, AL 35058
Phone (256) 737-2235

Organizations & group practices 6

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": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1114266434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331801",
            "telephone_number": "800-822-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-06",
        "last_updated": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-125488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.