Individual provider Active NPI

Timothy James Bryant, CRNA

  • Certified Registered Nurse Anesthetist
  • Elizabethtown, KY
National Provider Identifier
1235120965
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1105144 Issued in KY
Practice address
165 Sycamore Trace Rd
Elizabethtown, KY 42701-9545
Phone
(270) 300-2024
NPI assigned
Nov 2, 2005
Last updated
Mar 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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 1105144 KY Primary

Addresses

Primary practice location

165 Sycamore Trace Rd
Elizabethtown, KY 42701-9545

Mailing address

165 Sycamore Trace Rd
Elizabethtown, KY 42701-9545
Phone (270) 300-2024

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080417000132 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496833378 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ema Anesthesia, PSCGroup PAC ID 7911174552, 9 clinicians
Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians

Practice addresses (Care Compare)

101 Financial PL
Suite B103
Elizabethtown, KY 42701-8481
Phone (270) 660-7080

913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone (270) 706-1212

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1105144KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 19, 2024 Accepting new patients
Professional Anesthesia Services of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients
Anesthesia Care Enterprises, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1118 Woodland Dr
Elizabethtown, KY 42701
Phone (270) 769-0167

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

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, 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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1235120965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SYCAMORE TRACE RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019545",
            "telephone_number": "270-300-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 SYCAMORE TRACE RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019545",
            "telephone_number": "270-300-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1105144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.