NPIMap

Organization Active NPI

One Anesthesia PLLC

  • Anesthesiology Physician
  • Louisville, KY
National Provider Identifier
1174513246
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ONE ANESTHESIA PLLC
Practice address
100 Mallard Creek Rd
Suite 320
Louisville, KY 40207-4194
Phone
(502) 473-2132
Fax
(502) 459-0923
NPI assigned
Oct 28, 2005
Last updated
Mar 13, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Authorized official

Name
John E. Haas, MD
Title
President
Phone
(502) 473-2132

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU
Certified Registered Nurse Anesthetist 367500000X NU

Addresses

Primary practice location

100 Mallard Creek Rd
Suite 320
Louisville, KY 40207-4194

Mailing address

PO Box 70354
Louisville, KY 40270-0354
Phone (502) 473-2132

Other identifiers 2

IdentifierTypeStateIssuer
74900598MedicaidKY
65911513MedicaidKY

Other names 1

  • Williams and Wagner PSC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140204000105 IN Part B Supplier - Clinic/Group Practice 7113816174 Receives reassigned benefits from 23 practitioners
Practice locations: Jeffersonville, IN; New Albany, IN; Scottsburg, IN

National Provider Directory

National Provider Directory

Locations

1220 Missouri Ave
Rm 2547
Jeffersonville, IN 47130

2800 Breckenridge Ln
Louisville, KY 40220
Phone (502) 895-4263

Practitioners & affiliated clinicians

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1174513246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70354",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402700354",
            "telephone_number": "502-473-2132",
            "fax_number": "502-459-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD",
            "address_2": "SUITE 320",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074194",
            "telephone_number": "502-473-2132",
            "fax_number": "502-459-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "HAAS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-473-2132",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74900598",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65911513",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Williams and Wagner PSC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.