Individual provider Active NPI

Kelsey Downham

  • Certified Registered Nurse Anesthetist
  • Terre Haute, IN
National Provider Identifier
1316695224
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28237701A Issued in IN
Practice address
1606 N 7TH St
Terre Haute, IN 47804-2706
Phone
(812) 238-7000
NPI assigned
Mar 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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 28237701A IN Primary

Addresses

Primary practice location

1606 N 7TH St
Terre Haute, IN 47804-2706

Mailing address

472 Guthrie Rd
Bedford, IN 47421-6910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221024001038 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981070570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iceland Anesthesia Management LLCGroup PAC ID 7618372996, 75 clinicians

Practice addresses (Care Compare)

1606 N 7TH St
Terre Haute, IN 47804-2706
Phone (812) 238-7604

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28237701AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Iceland Anesthesia Management, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients

Locations

801 S Main St
Clinton, IN 47842
Phone (765) 832-1212

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 1

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 2

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": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1316695224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 GUTHRIE RD",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474216910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 N 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042706",
            "telephone_number": "812-238-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOWNHAM",
        "first_name": "KELSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28237701A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.