Individual provider Active NPI

Wesley Andrew Henderson, CRNA

  • Certified Registered Nurse Anesthetist
  • Tell City, IN
National Provider Identifier
1174877377
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
90868 Issued in TN
Practice address
8885 Indiana-237
Tell City, IN 47586
Phone
(812) 547-7011
NPI assigned
Nov 9, 2012
Last updated
Jun 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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 90868 TN Primary

Addresses

Primary practice location

8885 Indiana-237
Tell City, IN 47586

Mailing address

468 Fonso Cir
Bowling Green, KY 42104-5582

Other identifiers 1

IdentifierTypeStateIssuer
7100228600MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130109000409 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032362785 Reassigns benefits to 1 organization
I20160421002011 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032362785 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Pain Associates PLLCGroup PAC ID 0941441919, 156 clinicians
Anesthesiology Group Associates PCGroup PAC ID 0547233959, 47 clinicians

Practice addresses (Care Compare)

2609 New Hartford Rd
Suite 3
Owensboro, KY 42303-1316
Phone (812) 476-7111

3700 Washington Ave
Evansville, IN 47714-0541
Phone (812) 473-0181

700 Kimber LN
Evansville, IN 47715-2803
Phone (812) 476-7111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.99 of 100Reported as group
Quality
81.97
Promoting interoperability
97
Improvement activities
40
Cost
77.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
90868TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Pain Associates PLLC CurrentSince Apr 23, 2023 Accepting new patients
Anesthesiology Group Associates PC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2018 Accepting new patients
Commonwealth Pain Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 23, 2023 Accepting new patients
Eye Care Surgery Center of Evansville, LLC CurrentSince Oct 1, 2019 Accepting new patients
South Central Ohio Anesthesia, LLC Past Accepting new patients

Locations

1418 College Dr
Mount Carmel, IL 62863
Phone (618) 262-8621

1001 Walnut St
Evansville, IN 47713
Phone (812) 421-2020

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

6540 Logan Dr
#3
Evansville, IN 47715
Phone (812) 402-9620

6540 Logan Dr
Ste 3
Evansville, IN 47715
Phone (812) 402-3937

700 Kimber Ln
Evansville, IN 47715

520 S 7th St
Ste 159
Vincennes, IN 47591
Phone (812) 962-7890

309 11th St
Carrollton, KY 41008
Phone (502) 732-3241

252 Whittington Pkwy
Louisville, KY 40222
Phone (502) 423-7246

2609 New Hartford Rd
Ste 3
Owensboro, KY 42303
Phone (270) 417-2000

120 Executive Park
St Matthews, KY 40207
Phone (502) 409-9925

Interoperability endpoints

  • Direct secure messaging: wesley.henderson.1@16521.direct.athenahealth.com

Organizations & group practices 6

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.

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": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1174877377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 FONSO CIR",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8885 INDIANA-237",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "47586",
            "telephone_number": "812-547-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "WESLEY",
        "middle_name": "ANDREW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-09",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "90868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100228600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tell City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.