Active NPI
Kelly A Heine, CRNA
- Certified Registered Nurse Anesthetist
- Council Bluffs, IA
National Provider Identifier
1497073761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 62406
- Practice address
- 201 Ridge St
Suite 102
Council Bluffs, IA 51503-4643 - Phone
- (712) 322-5565
- Fax
- (712) 322-5566
- NPI assigned
- May 12, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 62406 | NE | Primary |
Addresses
Primary practice location
201 Ridge St
Suite 102
Council Bluffs, IA 51503-4643
Mailing address
PO Box 1988
Council Bluffs, IA 51502-1988
Phone (712) 322-5565
Other names 1
- Kelly A Kegley
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62406 | NE | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hypnos Anesthesia PC | Current | Accepting new patients | |
| Medical Anesthesia Associates PC | Past | Accepting new patients |
Locations
7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Omaha, NE
- NPI 1699837682
-
- Certified Registered Nurse Anesthetist
- Omaha, NE
- NPI 1376936112
-
- Pain Medicine (Anesthesiology) Physician
- Omaha, NE
- NPI 1144626581
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432166400000",
"number": "1497073761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1988",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515021988",
"telephone_number": "712-322-5565",
"fax_number": "712-322-5566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 RIDGE ST",
"address_2": "SUITE 102",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515034643",
"telephone_number": "712-322-5565",
"fax_number": "712-322-5566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINE",
"first_name": "KELLY",
"middle_name": "A",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-12",
"last_updated": "2015-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NE",
"license": "62406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "KEGLEY",
"middle_name": "A",
"credential": "CRNA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.