Individual provider Active NPI

Kristen L Walker-Payne, CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1497747836
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3003075 Issued in KY
Practice address
13307 Magisterial Dr
Louisville, KY 40223-4212
Phone
(502) 386-6501
Fax
(833) 731-0413
NPI assigned
Aug 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA10134 OH
Registered Nurse 163W00000X 1076646 KY
Certified Registered Nurse Anesthetist 367500000X RN0000112011 TN
Certified Registered Nurse Anesthetist 367500000X 3003075 KY Primary

Addresses

Primary practice location

13307 Magisterial Dr
Louisville, KY 40223-4212

Mailing address

13307 Magisterial Dr
Louisville, KY 40223-4212
Phone (502) 386-6501

Other identifiers 2

IdentifierTypeStateIssuer
74001363MedicaidKY
3632466MedicaidTN

Other names 1

  • Kristen L Payne Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100818000050 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527047612 Reassigns benefits to 3 organizations
I20210211002033 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527047612 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1076646KYMDRegistered Nurse
002685CTMDMedical Physician Assistant
3003075KYMDCertified Registered Nurse Anesthetist
NA10134OHMDCertified Registered Nurse Anesthetist
RN0000112011TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lec Ancillary PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 11, 2021 Accepting new patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2022 Accepting new patients
Providian Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2020 Accepting new patients
Waterbury Anesthesiology Assoc. Inc Past Accepting new patients
Anesthesia and Pain Consultants,P.C. Nurse Anesthetist, Certified Registered PastSince Mar 1, 2000 Accepting new patients
Rvlwf Michigan PLLC Past Accepting new patients
Licking Memorial Professional Corporation Past Accepting new patients
Louisville Endoscopy Center, PLLC PastSince Jan 11, 2021 Accepting new patients
Anesthesiology Consultants Enterprises, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

7145 E Virginia St
Ste 1000
Evansville, IN 47715
Phone (812) 476-6166

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322

9202 Leesgate Rd
Louisville, KY 40222
Phone (502) 276-5554

2511 Terra Crossing Blvd
Louisville, KY 40245
Phone (502) 589-9488

1400 Poplar Level Rd
Ste 2
Louisville, KY 40217
Phone (502) 452-9567

989 Medical Park Dr
Maysville, KY 41056
Phone (606) 759-3112

175 Hospital Dr
Winchester, KY 40391
Phone (859) 745-3500

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1497747836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13307 MAGISTERIAL DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234212",
            "telephone_number": "502-386-6501",
            "fax_number": "833-731-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13307 MAGISTERIAL DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234212",
            "telephone_number": "502-386-6501",
            "fax_number": "833-731-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER-PAYNE",
        "first_name": "KRISTEN",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "NA10134",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1076646",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000112011",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3003075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74001363",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3632466",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "PAYNE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.