Individual provider Active NPI

Timothy Keith Kaney, CRNA

  • Certified Registered Nurse Anesthetist
  • Bristol, TN
National Provider Identifier
1356708945
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
183498 Issued in NC
Practice address
210 Clark Rd
Bristol, TN 37620-7400
Phone
(423) 967-8764
NPI assigned
Jan 27, 2016
Last updated
Feb 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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 183498 NC Primary

Addresses

Primary practice location

210 Clark Rd
Bristol, TN 37620-7400

Mailing address

1144 N Road St
Elizabeth City, NC 27909-3473
Phone (252) 384-2610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160316001605 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789980780 Reassigns benefits to 5 organizations
I20180611000098 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789980780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Charlotte Support Services, PLLCGroup PAC ID 1951888551, 20 clinicians

Practice addresses (Care Compare)

1085 NE Gateway CT NE
Suite 180
Concord, NC 28025-2407
Phone (704) 927-6263

300 Billingsley Rd
Suite 200 B
Charlotte, NC 28211-1075
Phone (704) 927-6066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Sedation Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2024 Accepting new patients
Sarmc Anesthesia Specialist LLC CurrentSince Mar 25, 2016 Accepting new patients
Western Carolina Sedation Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients
Triad Sedation Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2019 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2018 Accepting new patients

Locations

112 Kinderton Blvd
#100
Advance, NC 27006
Phone (336) 765-0155

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

415 N Center St
Ste 300
Hickory, NC 28601
Phone (828) 328-3300

280 Broad St
Ste F
Kernersville, NC 27284
Phone (336) 765-6312

434 Kirby Rd
King, NC 27021

5200 N Croatan Hwy
Kitty Hawk, NC 27949
Phone (252) 261-4187

137 Mount Calvary Rd
#A
Thomasville, NC 27360

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

2025 Frontis Plaza Blvd
Ste 200
Winston Salem, NC 27103
Phone (336) 768-6621

6801 Governor Gc Peery Hwy
Richlands, VA 24641
Phone (276) 523-8600

600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1356708945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 N ROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093473",
            "telephone_number": "252-384-2610",
            "fax_number": "252-338-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 CLARK RD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207400",
            "telephone_number": "423-967-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANEY",
        "first_name": "TIMOTHY",
        "middle_name": "KEITH",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-27",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "183498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.