Individual provider Active NPI

Robert Scott Wiltrout, CRNA

  • Certified Registered Nurse Anesthetist
  • Corydon, IN
National Provider Identifier
1407852536
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28187882A Issued in IN
Practice address
1141 Hospital Dr NW
Corydon, IN 47112-2164
Phone
(812) 738-4251
NPI assigned
Jun 23, 2005
Last updated
Nov 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 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 RN502550L PA
Certified Registered Nurse Anesthetist 367500000X 28187882A IN Primary

Addresses

Primary practice location

1141 Hospital Dr NW
Corydon, IN 47112-2164

Mailing address

PO Box 38
Evansville, IN 47701-0038
Phone (812) 738-4251

Other practice location 1

Bayne-Jones Army Community Hospital
1585 third St.
Fort Polk, LA 71459
Phone (337) 531-3517

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robertwiltrout@dchpm.allscriptsdirect.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090520000009 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577590124 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians

Practice addresses (Care Compare)

913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone (270) 706-1212

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
TRH Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 19, 2023 Accepting new patients
Professional Anesthesia Services of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients
Louisville Endoscopy Center, PLLC Past Accepting new patients
Laurel Anesthesia Associates, PC Past Accepting new patients
Western Pennsylvania Anesthesia Associates, LTD. Past Accepting new patients
Latrobe Anesthesia Associates, Inc Past Accepting new patients

Locations

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

4960 Norton Healthcare Blvd
Louisville, KY 40241
Phone (502) 446-8000

4000 Kresge Way
St Matthews, KY 40207
Phone (502) 459-7902

Organizations & group practices 7

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1407852536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477010038",
            "telephone_number": "812-738-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 HOSPITAL DR NW",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471122164",
            "telephone_number": "812-738-4251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Bayne-Jones Army Community Hospital",
            "address_2": "1585 third St.",
            "address_purpose": "LOCATION",
            "city": "Fort Polk",
            "state": "LA",
            "postal_code": "71459",
            "country_code": "US",
            "telephone_number": "337-531-3517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILTROUT",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN502550L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28187882A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robertwiltrout@dchpm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1141 Hospital Dr NW",
            "city": "Corydon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471122164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corydon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.