Active NPI
Charles M Kirksey, CRNA
- Certified Registered Nurse Anesthetist
- Monticello, KY
National Provider Identifier
1366499238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 3002657
- Practice address
- 166 Hospital St
Monticello, KY 42633-2416 - Phone
- (606) 348-9343
- Fax
- (606) 348-0333
- NPI assigned
- May 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 3002657 | KY | Primary |
Addresses
Primary practice location
166 Hospital St
Monticello, KY 42633-2416
Mailing address
166 Hospital St
Monticello, KY 42633-2416
Phone (606) 348-9343
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 610847215001 | Other | KY | TRICARE |
| 74900994 | Medicaid | KY | |
| 610847215 | Other | KY | CHA HEALTH |
| 74009887 | Medicaid | KY | |
| 000000108553 | Other | KY | ANTHEM BC & BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3002657 | KY | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wayne County Hospital Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Monticello, KY
- NPI 1841239332
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473724800000",
"number": "1366499238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 HOSPITAL ST",
"city": "MONTICELLO",
"state": "KY",
"postal_code": "426332416",
"telephone_number": "606-348-9343",
"fax_number": "606-348-0333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 HOSPITAL ST",
"city": "MONTICELLO",
"state": "KY",
"postal_code": "426332416",
"telephone_number": "606-348-9343",
"fax_number": "606-348-0333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRKSEY",
"first_name": "CHARLES",
"middle_name": "M",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-27",
"last_updated": "2016-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "KY",
"license": "3002657",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "610847215001",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74900994",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHA HEALTH",
"identifier": "610847215",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74009887",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC & BS",
"identifier": "000000108553",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monticello, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.