Organization Active NPI

Bowling Green Anesthesiology Associates, PSC

  • Anesthesiology Physician
  • Bowling Green, KY
National Provider Identifier
1124058896
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
BOWLING GREEN ANESTHESIOLOGY ASSOCIATES, PSC
Practice address
1725 Ashley Cir
Suite 209a
Bowling Green, KY 42104-3337
Phone
(270) 782-9994
Fax
(270) 842-5048
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Authorized official

Name
Stacia Decker
Title
Office Manager
Phone
(270) 782-9994

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

1725 Ashley Cir
Suite 209a
Bowling Green, KY 42104-3337

Mailing address

PO Box 2020
Bowling Green, KY 42102-2020
Phone (270) 782-9994

Other identifiers 1

IdentifierTypeStateIssuer
65908048MedicaidKY

National Provider Directory

National Provider Directory

Locations

1228 Ashley Cir
Bowling Green, KY 42104
Phone (270) 781-1237

1725 Ashley Cir
Ste 209A
Bowling Green, KY 42104
Phone (270) 782-9994

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264550400000",
    "number": "1124058896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2020",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421022020",
            "telephone_number": "270-782-9994",
            "fax_number": "270-842-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 ASHLEY CIR",
            "address_2": "SUITE 209A",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043337",
            "telephone_number": "270-782-9994",
            "fax_number": "270-842-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWLING GREEN ANESTHESIOLOGY ASSOCIATES, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2010-01-27",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "STACIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-782-9994"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65908048",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.