Individual provider Active NPI

Heith Willis Robertson, MSN/CRNA

  • Certified Registered Nurse Anesthetist
  • Madisonville, KY
National Provider Identifier
1306083092
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
5899A Issued in KY
Practice address
900 Hospital Dr
Madisonville, KY 42431-1644
Phone
(270) 825-5100
NPI assigned
Jan 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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 5899A KY Primary

Addresses

Primary practice location

900 Hospital Dr
Madisonville, KY 42431-1644

Mailing address

200 Clinic Dr
Madisonville, KY 42431-1661

Other identifiers 2

IdentifierTypeStateIssuer
7100060970MedicaidKY
000000599525OtherKYANTHEM BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090212000394 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446315147 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Anesthesia PLLCGroup PAC ID 9830509686, 19 clinicians

Practice addresses (Care Compare)

900 Hospital Dr
Madisonville, KY 42431-1644
Phone (270) 825-5100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
5899AKYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Trigg County Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 19, 2021 Accepting new patients
Covenant Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2020 Accepting new patients
Trigg County Hospital, Inc CurrentSince Feb 19, 2021 Accepting new patients

Locations

254 Main St
Cadiz, KY 42211
Phone (270) 522-3215

425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322

900 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3900

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 and National Provider Directory roles.

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": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1306083092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HOSPITAL DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311644",
            "telephone_number": "270-825-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "HEITH",
        "middle_name": "WILLIS",
        "credential": "MSN/CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-16",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "5899A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100060970",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000599525",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.