Individual provider Active NPI

Roger K Colbert, CRNA

  • Certified Registered Nurse Anesthetist
  • Bardstown, KY
National Provider Identifier
1548217201
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1053494 Issued in KY
Practice address
4305 New Shepherdsville Rd
Bardstown, KY 40004-9019
Phone
(502) 350-5000
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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 1053494 KY Primary

Addresses

Primary practice location

4305 New Shepherdsville Rd
Bardstown, KY 40004-9019

Mailing address

PO Box 1160
Bardstown, KY 40004-4160
Phone (859) 276-6611

Other identifiers 2

IdentifierTypeStateIssuer
000000271994OtherKYBCBS
74346503MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
510TNMDAthletic Trainer
1053494KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Flaget Healthcare, Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Premier Anesthesia of Indiana PC Past Accepting new patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiology Medical Services PSC Past Accepting new patients
Pineville Community Hospital Association, Inc. Past Accepting new patients
Pineville Community Hospital Association, Inc. Past Accepting new patients

Organizations & group practices 6

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1548217201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1160",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400044160",
            "telephone_number": "859-276-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 NEW SHEPHERDSVILLE RD",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400049019",
            "telephone_number": "502-350-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBERT",
        "first_name": "ROGER",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1053494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000271994",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74346503",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bardstown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.