NPIMap

Organization Active NPI

Kinetic Anesthesia Services

  • Anesthesiology Physician
  • Barboursville, WV
National Provider Identifier
1306546445
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
KINETIC ANESTHESIA SERVICES
Practice address
22 Diamond Dr
Barboursville, WV 25504-9310
Phone
(304) 942-5808
Fax
(304) 208-8485
NPI assigned
Mar 7, 2023
Last updated
Mar 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

Name
Jamie Vance, CRNANPI 1033483466
Title
Owner
Phone
(304) 942-5808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

22 Diamond Dr
Barboursville, WV 25504-9310

Mailing address

PO Box 4100
Barboursville, WV 25504-4100
Phone (304) 955-6200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230626003579 WV Part B Supplier - Clinic/Group Practice 4486012234 Receives reassigned benefits from 8 practitioners
Practice locations: Barboursville, WV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1306546445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4100",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255044100",
            "telephone_number": "304-955-6200",
            "fax_number": "304-399-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 DIAMOND DR",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255049310",
            "telephone_number": "304-942-5808",
            "fax_number": "304-208-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC ANESTHESIA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-07",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "VANCE",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-942-5808",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barboursville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.