Individual provider Active NPI

Rachel Kelley, CRNA

  • Certified Registered Nurse Anesthetist
  • Birmingham, AL
National Provider Identifier
1538525654
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-122662 Issued in AL
Practice address
810 Saint Vincents Dr
Birmingham, AL 35205
Phone
(205) 939-7000
NPI assigned
Jan 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-122662 AL Primary

Addresses

Primary practice location

810 Saint Vincents Dr
Birmingham, AL 35205

Mailing address

1919 Oxmoor Rd
Birmingham, AL 35209-3502

Other practice location 1

2655 Northwinds Pkwy
Alpharetta, GA 30009-2280
Phone (770) 643-5619

Other names 1

  • Rachel Rickett Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160204000993 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638473093 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Montgomery PCGroup PAC ID 5799684148, 117 clinicians

Practice addresses (Care Compare)

2105 E S Blvd
Montgomery, AL 36116-2409
Phone (334) 286-3579

400 Taylor Rd
Montgomery, AL 36117-3512
Phone (334) 277-8330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-122662ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Montgomery PC Nurse Anesthetist, Certified Registered CurrentSince Jan 5, 2016 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Dec 11, 2016 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

400 Taylor Rd
Montgomery, AL 36117
Phone (334) 213-6287

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

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.

Hospital & facility affiliations 1

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": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1538525654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 OXMOOR RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352093502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 SAINT VINCENTS DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35205",
            "telephone_number": "205-939-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2655 Northwinds Pkwy",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300092280",
            "country_code": "US",
            "telephone_number": "770-643-5619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "RACHEL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-122662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "RICKETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.