Individual provider Active NPI

Wesley Oliver

  • Certified Registered Nurse Anesthetist
  • Bowling Green, KY
National Provider Identifier
1386216323
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3016633 Issued in KY
Practice address
250 Park St
Bowling Green, KY 42101-1795
Phone
(270) 745-1111
Fax
(270) 745-1026
NPI assigned
Jul 9, 2021
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3016633 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

250 Park St
Bowling Green, KY 42101-1795

Mailing address

8234 Booth Bay Dr
Hixson, TN 37343-2084
Phone (931) 260-6842

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012002069 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850799412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 Park St
Bowling Green, KY 42101-1760
Phone (270) 745-1111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3016633KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 7, 2021 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Sep 7, 2021 Accepting new patients
Northstar Anesthesia of Kentucky, PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 30, 2022 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

1000 Breckenridge St
Ste 100
Owensboro, KY 42303
Phone (270) 683-2751

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

Organizations & group practices 4

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 1

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": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1386216323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8234 BOOTH BAY DR",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373432084",
            "telephone_number": "931-260-6842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011795",
            "telephone_number": "270-745-1111",
            "fax_number": "270-745-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "WESLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3016633",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.