NPIMap

Organization Active NPI

Mid-South Anesthesia, PLLC

  • Certified Registered Nurse Anesthetist
  • Lexington, KY
National Provider Identifier
1487929121
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MID-SOUTH ANESTHESIA, PLLC
Practice address
2901 Richmond Rd
Suite 130 PMB 302
Lexington, KY 40509-1771
Phone
(859) 200-3083
NPI assigned
Mar 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Authorized official

Name
Timothy Bentley, CRNANPI 1457432536
Title
Owner
Phone
(859) 200-3083

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

2901 Richmond Rd
Suite 130 PMB 302
Lexington, KY 40509-1771

Mailing address

2901 Richmond Rd
Suite 130 PMB 302
Lexington, KY 40509-1771
Phone (859) 200-3083

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120807000729 KY Part B Supplier - Clinic/Group Practice 3173779188 Receives reassigned benefits from 15 practitioners
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory

Locations

2620 Wilhite Dr
Lexington, KY 40503
Phone (859) 278-6031

2901 Richmond Rd
Ste 130
Lexington, KY 40509
Phone (859) 200-3083

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1487929121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 RICHMOND RD",
            "address_2": "SUITE 130 PMB 302",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091771",
            "telephone_number": "859-200-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 RICHMOND RD",
            "address_2": "SUITE 130 PMB 302",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091771",
            "telephone_number": "859-200-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH ANESTHESIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-200-3083",
        "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.