Individual provider Active NPI

Andrea Infantino

  • Certified Registered Nurse Anesthetist
  • Fort Campbell, KY
National Provider Identifier
1508238916
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
20948 Issued in TN
Practice address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone
(270) 798-8400
NPI assigned
Oct 25, 2015
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 20948 TN Primary
Certified Registered Nurse Anesthetist 367500000X R203095 MD

Addresses

Primary practice location

650 Joel Dr
Fort Campbell, KY 42223-5318

Mailing address

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (847) 848-2630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY, IN, WA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20160428001913 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850690637 Reassigns benefits to 4 organizations
I20230802000569 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850690637 Reassigns benefits to 1 organization
I20240104001881 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850690637 Reassigns benefits to 1 organization
I20240626002919 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850690637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Maryland School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trigg County Hospital, IncGroup PAC ID 5193620805, 33 clinicians
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

254 Main St
Cadiz, KY 42211-9153
Phone (270) 522-3215

4011 Gateway Blvd
Newburgh, IN 47630-8947
Phone (812) 450-7338

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R203095MDMDCertified Registered Nurse Anesthetist
20948TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 1 of Mason County Nurse Anesthetist, Certified Registered CurrentSince Jun 15, 2024 Accepting new patients
Integrated Anesthesia Services, PLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2020 Accepting new patients
Anesthesia Medical Group, PC Nurse Anesthetist, Certified Registered CurrentSince Mar 5, 2016 Accepting new patients
Public Hospital District No 1 of Mason County Wa CurrentSince Jun 15, 2024 Accepting new patients
Deaconess Hospital, Inc Current Accepting new patients
Deaconess Hospital Inc CurrentSince Nov 8, 2023 Accepting new patients
Trigg County Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince May 21, 2023 Accepting new patients
Amsurg Hermitage Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince May 9, 2020 Accepting new patients
Deaconess Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 8, 2023 Accepting new patients
Trigg County Hospital, Inc CurrentSince May 21, 2023 Accepting new patients
Forefront Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 16, 2021 Accepting new patients

Locations

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

254 Main St
Cadiz, KY 42211
Phone (270) 522-3215

400 10th St E
Waconia, MN 55387

280 Warfield Blvd
Clarksville, TN 37043
Phone (931) 551-9605

437 E Main St
Gallatin, TN 37066
Phone (615) 452-8705

5653 Frist Blvd
Hermitage, TN 37076
Phone (615) 232-8812

9430 Park West Blvd
Ste 320
Knoxville, TN 37923
Phone (615) 441-4477

110 29th Ave N
Ste 202
Nashville, TN 37203
Phone (615) 327-7870

110 29th Ave N
Ste 301
Nashville, TN 37203
Phone (615) 327-3404

901 Mountain View Dr
Bldg 1
Shelton, WA 98584
Phone (360) 426-1611

Organizations & group practices 11

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1445731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1508238916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "847-848-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INFANTINO",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-25",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "20948",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R203095",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.