Individual provider Active NPI

Nicholas Kelsey, REGISTERED NURSE

  • Certified Registered Nurse Anesthetist
  • Madison, TN
National Provider Identifier
1154090702
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4015069 Issued in KY
Practice address
315 Hospital Dr
Madison, TN 37115-5030
Phone
(606) 271-3157
NPI assigned
Sep 8, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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 4015069 KY Primary

Addresses

Primary practice location

315 Hospital Dr
Madison, TN 37115-5030

Mailing address

315 Hospital Dr
Madison, TN 37115-5030
Phone (606) 271-3157

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240409002291 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446698526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Capital Anesthesia Solutions of Kentucky LLCGroup PAC ID 0446681548, 37 clinicians

Practice addresses (Care Compare)

305 Langdon St
Somerset, KY 42503-2750
Phone (606) 679-7441

Hospital & facility affiliations

  • Lake Cumberland Regional Hospital Hospital, Somerset, KY, CCN 180132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Anesthesia Solutions of Kentucky LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 24, 2024 Accepting new patients

Locations

305 Langdon St
Somerset, KY 42503
Phone (606) 451-2994

301 Langdon St
Somerset, KY 42503
Phone (606) 678-9688

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1154090702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 HOSPITAL DR",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155030",
            "telephone_number": "606-271-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 HOSPITAL DR",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155030",
            "telephone_number": "606-271-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "NICHOLAS",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-08",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "4015069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.