Individual provider Active NPI

Kenneth Bidwell, CRNA

  • Certified Registered Nurse Anesthetist
  • Tampa, FL
National Provider Identifier
1194820407
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9185166 Issued in FL
Practice address
2727 W. Martin Luther King Blvd
Ste #300
Tampa, FL 33607
Phone
(813) 870-4436
Fax
(813) 870-4084
NPI assigned
Sep 13, 2006
Last updated
Nov 7, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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 ARNP9185166 FL Primary

Addresses

Primary practice location

2727 W. Martin Luther King Blvd
Ste #300
Tampa, FL 33607

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone (800) 394-4445

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
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
38993TNMDEmergency Medicine Physician
ARNP9185166FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Simplified LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1194820407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464",
            "telephone_number": "800-394-4445",
            "fax_number": "706-868-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W. MARTIN LUTHER KING BLVD",
            "address_2": "STE #300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-870-4436",
            "fax_number": "813-870-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIDWELL",
        "first_name": "KENNETH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9185166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.