Individual provider Active NPI

Anastasia Muncy

  • Certified Registered Nurse Anesthetist
  • Edgewood, KY
National Provider Identifier
1194092726
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1112631 Issued in KY
Practice address
20 Medical Village Dr
Suite 258
Edgewood, KY 41017-5401
Phone
(859) 341-7246
NPI assigned
Nov 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28248130A IN
Certified Registered Nurse Anesthetist 367500000X 1112631 KY Primary

Addresses

Primary practice location

20 Medical Village Dr
Suite 258
Edgewood, KY 41017-5401

Mailing address

20 Medical Village Dr
Suite 258
Edgewood, KY 41017-5401
Phone (859) 341-7246

Other practice location 1

473 E Greenville Ave
Winchester, IN 47394-9436
Phone (765) 584-0107

Other identifiers 3

IdentifierTypeStateIssuer
000000747638OtherANTHEM BS
0061651MedicaidOH
7100190520MedicaidKY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120221000818 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092973123 Reassigns benefits to 1 organization
I20190129000469 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092973123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7500 State Rd
Cincinnati, OH 45255-2439
Phone (513) 624-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28248130AINMDCertified Registered Nurse Anesthetist
1112631KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. CurrentSince Feb 4, 2019 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Feb 4, 2019 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2012 Accepting new patients
Regional Anesthesia Group Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1331 S A St
Elwood, IN 46036
Phone (765) 552-4000

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

473 SE Greenville Ave
Winchester, IN 47394
Phone (765) 584-0004

20 Medical Village Dr
Ste 258
Edgewood, KY 41017
Phone (606) 341-2666

3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209

L6147
Cincinnati, OH 45270

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1194092726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DR",
            "address_2": "SUITE 258",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175401",
            "telephone_number": "859-341-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DR",
            "address_2": "SUITE 258",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175401",
            "telephone_number": "859-341-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "473 E Greenville Ave",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "IN",
            "postal_code": "473949436",
            "country_code": "US",
            "telephone_number": "765-584-0107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNCY",
        "first_name": "ANASTASIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28248130A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1112631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BS",
            "identifier": "000000747638",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061651",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100190520",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.