Keith W Green, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

28138655A Issued in IN

Practice address

800 W 9TH St
Jasper, IN 47546-2514

Phone

(812) 482-0643

Fax

(812) 482-0214

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Indiana University Health IncGroup PAC ID 2365350675, 56 clinicians

Indiana University Health Bedford IncGroup PAC ID 2668383092, 7 clinicians

Indiana University Health Paoli IncGroup PAC ID 2668426016, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Bedford Hospital Hospital, Bedford, IN, CCN 151328
• Indiana University Health Hospital, Indianapolis, IN, CCN 150056

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Indiana University Health Bedford, Inc

  • Clinical Pathology Physician
  • Bedford, IN
  • NPI 1871036962

  IN, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Indiana University Health Paoli Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Paoli, IN
  • NPI 1457519324

  IN

  Medicare reassignment Care Compare group NPD
• Indiana University Health, Inc

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1376586719

  IN

  Medicare reassignment Care Compare group NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777

  IN, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Ivory Coast Anesthesia Management LLC

  • Anesthesiology Physician
  • Jasper, IN
  • NPI 1083484000

  IN, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  IN, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Indiana University Health Paoli Inc

  • Rural Health Clinic/Center
  • Paoli, IN
  • NPI 1679182190
  Care Compare group NPD
• Indiana University Health Bedford, Inc

  • Critical Access Hospital
  • Bedford, IN
  • NPI 1548260284
  Care Compare group
• Indiana University Health Bedford, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Bedford, IN
  • NPI 1457329807
  Care Compare group
• Indiana University Health Inc

  • Community/Retail Pharmacy
  • Fishers, IN
  • NPI 1073898839
  Care Compare group
• Indiana University Health Inc

  • Community/Retail Pharmacy
  • Avon, IN
  • NPI 1114995784
  Care Compare group
• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare group

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

• Indiana University Health Bedford, Inc

  • Critical Access Hospital
  • Bedford, IN
  • NPI 1548260284

  Hospital

  Care Compare affiliation
• Indiana University Health Bedford, Inc.

  • Ambulance
  • Bedford, IN
  • NPI 1346218799

  Hospital

  Care Compare affiliation
• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1508920653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 W SKYVIEW DR",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475468214",
            "telephone_number": "812-634-9504",
            "fax_number": "812-634-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 9TH ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462514",
            "telephone_number": "812-482-0643",
            "fax_number": "812-482-0214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2209 John R Wooden Dr",
            "address_purpose": "LOCATION",
            "city": "Martinsville",
            "state": "IN",
            "postal_code": "461511840",
            "country_code": "US",
            "telephone_number": "765-349-6744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KEITH",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9261695",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28138655A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200157750A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "28138655",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "940070020",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC ID",
            "identifier": "000000211953",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "163460047",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgreen@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2209 John R Wooden Dr",
            "city": "Martinsville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461511840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shawntia Gramelspacher-Zehr, LSW
• Craig J Gramelspacher, O.D.
• Curt E Gramelspacher, O.D.
• Great Heights Physical Therapy
• Greater Jasper School Corporation
• Greene County General Hospital
• Greene County General Hospital
• Greene County General Hospital
• Gregory a. Berger DDS
• Gress Anesthesia Services P.C.

• All providers in Jasper, IN
• Certified Registered Nurse Anesthetist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.