Individual provider Active NPI

Crystal Desiree Kafer, CRNA

  • Certified Registered Nurse Anesthetist
  • North Las Vegas, NV
National Provider Identifier
1215208848
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN9268631 Issued in FL
Practice address
5815 Nuevo Leon St
Unit 4
North Las Vegas, NV 89031-3699
Phone
(813) 476-2396
NPI assigned
Jan 12, 2012
Last updated
Jan 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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 RN9268631 FL Primary

Addresses

Primary practice location

5815 Nuevo Leon St
Unit 4
North Las Vegas, NV 89031-3699

Mailing address

5815 Nuevo Leon St
Unit 4
North Las Vegas, NV 89031-3699
Phone (813) 476-2396

Other names 1

  • Crystal Desiree Rice Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220926002943 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092025148 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Practice addresses (Care Compare)

1034 Mar Walt Dr
Suite 300
Fort Walton Beach, FL 32547-6645
Phone (850) 315-9385

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9268631FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2022 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 29, 2024 Accepting new patients
Ams of Crestview LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 5, 2022 Accepting new patients
Destin Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 27, 2023 Accepting new patients
Mesa Az Endoscopy ASC LLC PastSince Oct 17, 2021 Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

400 Redstone Ave W
Crestview, FL 32536
Phone (850) 683-1555

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

4413 US Highway 331 S
Defuniak Springs, FL 32435
Phone (850) 892-5171

1225 Airport Rd
Destin, FL 32541
Phone (850) 650-7606

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 333-2050

1034 Mar Walt Dr
Unit 300
Ft Walton Bch, FL 32547
Phone (850) 315-9363

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

560 Jackson St N
Ste 200
St Petersburg, FL 33705
Phone (727) 388-7326

Organizations & group practices 5

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": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1215208848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5815 NUEVO LEON ST",
            "address_2": "UNIT 4",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890313699",
            "telephone_number": "813-476-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 NUEVO LEON ST",
            "address_2": "UNIT 4",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890313699",
            "telephone_number": "813-476-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAFER",
        "first_name": "CRYSTAL",
        "middle_name": "DESIREE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "RN9268631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "RICE",
            "middle_name": "DESIREE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.