Individual provider Active NPI

Iris A Horton, CRNA

  • Certified Registered Nurse Anesthetist
  • Corbin, KY
National Provider Identifier
1467452540
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1109859 Issued in KY
Practice address
275 Hwy 770
Corbin, KY 40701-4732
Phone
(865) 777-0909
Fax
(865) 777-0910
NPI assigned
Jul 29, 2005
Last updated
Jan 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 027825 TN
Certified Registered Nurse Anesthetist 367500000X 1109859 KY Primary
Certified Registered Nurse Anesthetist 367500000X 4909A KY

Addresses

Primary practice location

275 Hwy 770
Corbin, KY 40701-4732

Mailing address

12752 Kingston Pike
Ste E202
Knoxville, TN 37934-0948
Phone (865) 777-0909

Other identifiers 6

IdentifierTypeStateIssuer
3057362OtherTNBCBS NUMBER
74278250MedicaidKY
000000484172OtherKYBLUE CROSS/BLUE SHIELD
000000484172OtherKYANTHEM BCBS KY
3602454MedicaidTN
P00336403OtherKYRAILROAD MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1109859KYMDCertified Registered Nurse Anesthetist
4909AKYMDCertified Registered Nurse Anesthetist
027825TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Anesthesia Lakeway, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1467452540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12752 KINGSTON PIKE",
            "address_2": "STE E202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379340948",
            "telephone_number": "865-777-0909",
            "fax_number": "865-777-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 HWY 770",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407014732",
            "telephone_number": "865-777-0909",
            "fax_number": "865-777-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "IRIS",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "027825",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1109859",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "4909A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "3057362",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74278250",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000484172",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS KY",
            "identifier": "000000484172",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3602454",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00336403",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.