Individual provider Active NPI

Charles Henry Elliott II, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Lexington, KY
National Provider Identifier
1376375683
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1144341 Issued in KY
Practice address
1 Saint Joseph Dr
Lexington, KY 40504-3742
Phone
(859) 313-1000
NPI assigned
Aug 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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 1144341 KY Primary

Addresses

Primary practice location

1 Saint Joseph Dr
Lexington, KY 40504-3742

Mailing address

1081 Duval St
Lexington, KY 40515-6283
Phone (859) 374-0184

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926003690 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204367501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Anesthesia, PSCGroup PAC ID 5092627521, 181 clinicians

Practice addresses (Care Compare)

310 S Limestone
Lexington, KY 40508-3008
Phone (859) 252-6612

Hospital & facility affiliations

  • Saint Joseph Hospital Hospital, Lexington, KY, CCN 180010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1144341KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered CurrentSince Aug 30, 2024 Accepting new patients

Locations

4305 New Shepherdsville Rd
Bardstown, KY 40004
Phone (502) 350-5000

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

55 Foundation Dr
Flemingsburg, KY 41041
Phone (606) 849-2351

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

2115 Harrodsburg Rd
Lexington, KY 40504
Phone (859) 276-2520

3480 Yorkshire Medical Park
#100
Lexington, KY 40509
Phone (859) 514-0260

3475 Blazer Pkwy
Lexington, KY 40509
Phone (859) 514-0260

1 Saint Joseph Dr
Lexington, KY 40504
Phone (502) 350-5000

1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181

1001 Saint Joseph Ln
London, KY 40741
Phone (606) 330-6000

2511 Terra Crossing Blvd
Louisville, KY 40245
Phone (502) 589-9488

989 Medical Park Dr
Maysville, KY 41056
Phone (606) 759-3112

225 Falcon Dr
Mt Sterling, KY 40353
Phone (859) 497-5000

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

175 Hospital Dr
Winchester, KY 40391
Phone (859) 745-3500

Interoperability endpoints

  • Direct secure messaging: celliott292621@direct.stlukeshealth.org

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.

Hospital & facility affiliations 3

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": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1376375683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 DUVAL ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156283",
            "telephone_number": "859-374-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT JOSEPH DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043742",
            "telephone_number": "859-313-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CHARLES",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1144341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 15, 2024; 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.