KJB Anesthesia, PLLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

KJB ANESTHESIA, PLLC

Practice address

1010 S Coulter St
Amarillo, TX 79106-1781

Phone

(866) 877-2762

Fax

(866) 992-7144

NPI assigned

Jun 30, 2021

Organization subpart

No

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

Authorized official

Name

Kelly J Black, CRNA

Title

Owner

Phone

(866) 877-2762

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1396315487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6467",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295026467",
            "telephone_number": "866-877-2762",
            "fax_number": "866-992-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061781",
            "telephone_number": "866-877-2762",
            "fax_number": "866-992-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KJB ANESTHESIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-877-2762",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212211106",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srichardson@coastalhcresources.com",
            "affiliation": "N",
            "endpointDescription": "WORK EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1010 S Coulter St",
            "city": "Amarillo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "791061781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrick James Kirkland, M.D.
• Ilan Kiselstein, DDS
• Lawrence Edward Kitchens III
• Donna Raef Kizziar, APRN, FNP-C
• Mason Kizziar, APRN-FNP, RNFA, CST
• Katrina D'Ann Klaehn, MA, LPC, LSOTP
• Klash Medical Billing Services
• Cara Rebecca Klaus
• John Wilfert Klein, M.D.
• Jon Sebastian Klein, MA, LPC-S, LSOTP

• Certified Registered Nurse Anesthetist in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.