Individual provider Active NPI

Kelly Walker Beirne, CRNA

  • Certified Registered Nurse Anesthetist
  • Indian Harbour Beach, FL
National Provider Identifier
1306809405
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2644822 Issued in FL
Practice address
2033 S Patrick Dr
Indian Harbour Beach, FL 32937-4418
Phone
(321) 773-9898
Fax
(321) 773-3354
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2358 SC
Certified Registered Nurse Anesthetist 367500000X 2644822 FL Primary

Addresses

Primary practice location

2033 S Patrick Dr
Indian Harbour Beach, FL 32937-4418

Mailing address

2033 S Patrick Dr
Indian Harbour Beach, FL 32937-4418
Phone (321) 773-9898

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040519001539 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597756478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beach Medical Specialists LLCGroup PAC ID 2860622776, 3 clinicians

Practice addresses (Care Compare)

2033 S Patrick Dr
Suite B
Indian Harbour Beach, FL 32937-4418
Phone (321) 773-9898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2644822FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Beach Medical Specialists LLC CurrentSince May 31, 2013 Accepting new patients
Beach Medical Imaging, PA Past Accepting new patients
Central Brevard Anesthesiologists, PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Spartanburg Hospital for Restorative Care Past Accepting new patients

Locations

2033 South Patrick Dr
Indian Harbour Beach, FL 32937
Phone (321) 773-9898

2033 South Patrick Dr
Ste B
Indian Harbour Beach, FL 32937
Phone (321) 773-9898

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1306809405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 S PATRICK DR",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374418",
            "telephone_number": "321-773-9898",
            "fax_number": "321-773-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 S PATRICK DR",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374418",
            "telephone_number": "321-773-9898",
            "fax_number": "321-773-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER BEIRNE",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "2358",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "2644822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Harbour Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.