Kevin James Maltais, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

181612 Issued in NC

Practice address

568 Ruin Creek Rd
Suite 105
Henderson, NC 27536-2880

Phone

(252) 436-1380

Fax

(252) 436-1851

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MSC Anesthesia IncGroup PAC ID 7517912579, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://phsfhir.primehealthcare.com/PHS-PRD-FHIR/api/FHIR/R4

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.

• MSC Anesthesia Inc

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073504346

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Floridian Anesthesia Services LLC

  • Anesthesiology Physician
  • Miami, FL
  • NPI 1598391195
  Medicare reassignment NPD
• Maria Parham Anesthesia and Physiatry Center, Inc

  • Specialist
  • Henderson, NC
  • NPI 1558435388
  NPD (past)
• Maria Parham Nephrology & Hypertension

  • Nephrology Physician
  • Henderson, NC
  • NPI 1679705875
  NPD (past)
• Garden City Hospital

  • Certified Registered Nurse Anesthetist
  • Garden City, MI
  • NPI 1023052420

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1447346499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 10TH ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 RUIN CREEK RD",
            "address_2": "SUITE 105",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362880",
            "telephone_number": "252-436-1380",
            "fax_number": "252-436-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTAIS",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024167055",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "181612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051607",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• LST Collections LLC
• Chad Garett Lubecki, DMD
• David Adam Mack, M.D.
• Takerah J Macon
• Katelyn Maglionico
• Maria Parham Anesthesia & Physiatry Center Inc. (Kerr Lake Orthopaedics)
• Maria Parham Anesthesia and Physiatry Center Inc (Dba Northern Carolina Cardiology)
• Maria Parham Anesthesia and Physiatry Center Inc (DBA Northern Carolina Surgical Associates)
• Maria Parham Anesthesia and Physiatry Center, Inc
• Maria Parham Anesthesia and Physiatry Center, Inc

• Certified Registered Nurse Anesthetist in Henderson, NC
• Providers in Henderson, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.