NPIMap

Organization Active NPI

Shriners Hospitals for Children

  • Anesthesiology Physician
  • Lexington, KY
National Provider Identifier
1336639780
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SHRINERS HOSPITALS FOR CHILDREN
Practice address
110 Conn Ter
Lexington, KY 40508-3206
Phone
(859) 266-2101
Fax
(859) 268-5636
NPI assigned
May 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2018

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

Authorized official

Name
Jerry G. Gantt
Title
President
Phone
(813) 281-0300

Specialties & licenses 1

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

Addresses

Primary practice location

110 Conn Ter
Lexington, KY 40508-3206

Mailing address

2900 N Rocky Point Dr
Tampa, FL 33607-1435
Phone (813) 281-0300

Other names 1

  • Shriners Hospitals for Children Pro Anesthesia Services-Lexington Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170210001728 KY Part B Supplier - Clinic/Group Practice 9133031933 Receives reassigned benefits from 50 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lexington, KY

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Shriners Hosp for Children49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

Locations

2425 Stockton Blvd
Sacramento, CA 95817
Phone (916) 453-2000

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525996800000",
    "number": "1336639780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N ROCKY POINT DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071435",
            "telephone_number": "813-281-0300",
            "fax_number": "813-281-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CONN TER",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405083206",
            "telephone_number": "859-266-2101",
            "fax_number": "859-268-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRINERS HOSPITALS FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A",
        "authorized_official_last_name": "GANTT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-281-0300"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shriners Hospitals for Children Pro Anesthesia Services-Lexington",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Shriners Hospitals for Children Pro Anesthesia Services-Lexington",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.

Verify at the official NPI Registry.