Individual provider Active NPI

John W. Sciarini, CRNA

  • Certified Registered Nurse Anesthetist
  • Madisonville, KY
National Provider Identifier
1124125760
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1076A Issued in KY
Practice address
200 Clinic Dr
Madisonville, KY 42431-1661
Phone
(270) 825-7200
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 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 1076A KY Primary

Addresses

Primary practice location

200 Clinic Dr
Madisonville, KY 42431-1661

Mailing address

200 Clinic Dr
Madisonville, KY 42431-1661
Phone (270) 825-7200

Other identifiers 3

IdentifierTypeStateIssuer
000000044272OtherBCBS PROVIDER NUMBER
1076AOtherKYLICENSE
74393315MedicaidKY

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

State licenses

LicenseStateTypeSpecialty
1076AKYMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1124125760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "270-825-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "270-825-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIARINI",
        "first_name": "JOHN",
        "middle_name": "W.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1076A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "000000044272",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1076A",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74393315",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.