Individual provider Active NPI

Gary Eddie Vesely, CRNA

  • Certified Registered Nurse Anesthetist
  • Sun City, AZ
National Provider Identifier
1518056134
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1813 Issued in CA
Practice address
10541 W Thunderbird Blvd
Sun City, AZ 85351-3006
Phone
(865) 777-0909
Fax
(865) 777-0910
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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 CRNA0010 AZ
Certified Registered Nurse Anesthetist 367500000X 034999 AZ
Certified Registered Nurse Anesthetist 367500000X 1813 CA Primary
Certified Registered Nurse Anesthetist 367500000X RN075834 AZ

Addresses

Primary practice location

10541 W Thunderbird Blvd
Sun City, AZ 85351-3006

Mailing address

12752 Kingston Pike
Ste E202
Knoxville, TN 37934-0948
Phone (865) 777-0909

Other identifiers 1

IdentifierTypeStateIssuer
144923MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190409002660 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527033810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adena Medical Group LLCGroup PAC ID 1153456579, 384 clinicians

Practice addresses (Care Compare)

1430 Columbus Ave
Washington Court House, OH 43160-1703
Phone (740) 335-1210

Merit-based Incentive Payment System (MIPS)

Final score
82.93 of 100Reported as group
Quality
64.42
Promoting interoperability
99
Improvement activities
40
Cost
73.2

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
034999AZMDCertified Registered Nurse Anesthetist
RN075834AZMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Anesthesia Highlands Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 23, 2019 Accepting new patients
Adena Medical Group LLC CurrentSince Aug 8, 2022 Accepting new patients
Resource Anesthesia Lakeway, Inc. Past Accepting new patients
Care for Kids of Arizona Past Accepting new patients
Squaw Peak Anesthesia Inc Nurse Anesthetist, Certified Registered PastSince Sep 5, 2021 Accepting new patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients
Squaw Peak Anesthesia Inc Past Accepting new patients

Locations

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

1275 N High St
Hillsboro, OH 45133
Phone (937) 393-5503

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

1430 Columbus Ave
Wshngtn Ct Hs, OH 43160
Phone (740) 333-2705

12752 Kingston Pike
Ste E202
Knoxville, TN 37934
Phone (877) 277-9030

Organizations & group practices 7

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1518056134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12752 KINGSTON PIKE",
            "address_2": "STE E202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379340948",
            "telephone_number": "865-777-0909",
            "fax_number": "865-777-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10541 W THUNDERBIRD BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513006",
            "telephone_number": "865-777-0909",
            "fax_number": "865-777-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESELY",
        "first_name": "GARY",
        "middle_name": "EDDIE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA0010",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "034999",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "1813",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "RN075834",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144923",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.