Active NPI
Tina Marie Kahwaty, CRNA
- Certified Registered Nurse Anesthetist
- Raleigh, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 74199
- Practice address
- 4420 Lake Boone TRL
Raleigh, NC 27607 - Phone
- (919) 784-3034
- NPI assigned
- Jul 19, 2006
- Last updated
- Aug 6, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | ARNP3196982 | FL | |
| Certified Registered Nurse Anesthetist | 367500000X | 74199 | NC | Primary |
Addresses
Primary practice location
4420 Lake Boone TRL
Raleigh, NC 27607
Mailing address
3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880
Phone (919) 873-9533
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8053382 | Medicaid | NC | |
| G3917 | Other | FL | BC/BS OF FLORIDA NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP3196982 | FL | MD | Certified Registered Nurse Anesthetist |
| 74199 | NC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of North Carolina, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| American Anesthesiology of North Carolina, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Anesthesia Unlimited Inc | Past | Accepting new patients | |
| Anesthesia Associates of Greater Miami, PA | Past | Accepting new patients |
Locations
3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705
4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034
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.
-
- Certified Registered Nurse Anesthetist
- Burlington, NC
- NPI 1053677195
Nurse Anesthetist, Certified Registered
-
dba Carolina Pain Consultants
- Pain Medicine (Anesthesiology) Physician
- Wake Forest, NC
- NPI 1942248547
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- South Miami, FL
- NPI 1497700140
-
- Anesthesiology Physician
- Panama City, FL
- NPI 1871519884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533513600000",
"number": "1306865001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SPRING FOREST RD",
"address_2": "SUITE 130",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276162880",
"telephone_number": "919-873-9533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4420 LAKE BOONE TRL",
"city": "RALEIGH",
"state": "NC",
"postal_code": "27607",
"telephone_number": "919-784-3034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAHWATY",
"first_name": "TINA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2018-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "FL",
"license": "ARNP3196982",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "74199",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8053382",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF FLORIDA NUMBER",
"identifier": "G3917",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; 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.