NPIMap

Individual provider Active NPI

Terry Keith Blue, CRNA

  • Certified Registered Nurse Anesthetist
  • Andover, KS
National Provider Identifier
1114909991
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP3243142 Issued in FL
Practice address
1108 E Waterview Dr
Andover, KS 67002-7996
Phone
(316) 425-8153
Fax
(316) 425-8153
NPI assigned
Nov 16, 2005
Last updated
Oct 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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 ARNP3243142 FL Primary

Addresses

Primary practice location

1108 E Waterview Dr
Andover, KS 67002-7996

Mailing address

1108 E Waterview Dr
Andover, KS 67002-7996
Phone (316) 425-8153

Other identifiers 2

IdentifierTypeStateIssuer
100252100AMedicaidKS
430056874MedicaidFL

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

LicenseStateTypeSpecialty
ARNP3243142FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Southwest Florida Anesthesia Plus Nurse Anesthetist, Certified Registered Past Accepting new patients
Ocala Regional Medical Center Anesthesia Inc Past Accepting new patients
Ft. Walton Beach Anesthesia Services LLC Past Accepting new patients
Wichita Anesthesiology Chartered Past Accepting new patients
World Wide Anesthesia Alliance Nurse Anesthetist, Certified Registered Past Accepting new patients
John M Graves DO LLC Past Accepting new patients
Florida Hospital Ocala Inc Past Accepting new patients
Michael E Donohoe Crna Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: terry.bluecrna.p2@direct.ocalaeye.nextgenshare.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1114909991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 E WATERVIEW DR",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670027996",
            "telephone_number": "316-425-8153",
            "fax_number": "316-425-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 E WATERVIEW DR",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670027996",
            "telephone_number": "316-425-8153",
            "fax_number": "316-425-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "TERRY",
        "middle_name": "KEITH",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3243142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100252100A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430056874",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.