Individual provider Active NPI

Andy Keller, CRNA

  • Certified Registered Nurse Anesthetist
  • Portsmouth, VA
National Provider Identifier
1578986287
Registry record updated Aug 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
716685 Issued in CA
Practice address
620 John Paul Jones Cir
Anesthesia Dept
Portsmouth, VA 23708-2197
Phone
(757) 953-3300
NPI assigned
Jan 31, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2017

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 716685 CA Primary

Addresses

Primary practice location

620 John Paul Jones Cir
Anesthesia Dept
Portsmouth, VA 23708-2197

Mailing address

2111 Brennhaven Tral
Chesapeake, VA 23323
Phone (520) 331-7401

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171018001316 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032485107 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Uniformed Services Uhs Fe Hebert School of Med, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Premier Anesthesia of Virginia LLCGroup PAC ID 1951722362, 48 clinicians

Practice addresses (Care Compare)

100 Sentara Cir
Williamsburg, VA 23188-5713
Phone (678) 690-7826

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
716685CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Dec 1, 2024 Accepting new patients
Capital Digestive Care ,LLC Current Accepting new patients
Eastern Virginia Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2021 Accepting new patients
Capital Digestive Care LLC CurrentSince Dec 17, 2024 Accepting new patients
Premier Anesthesia of Virginia LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2020 Accepting new patients
Bayview Physician Services, PC CurrentSince Dec 1, 2024 Accepting new patients
Northstar Anesthesia of Virginia, LLC CurrentSince Jan 1, 2025 Accepting new patients
Capital Digestive Care, LLC CurrentSince Dec 17, 2024 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

208 Carmichael Way
Chesapeake, VA 23322
Phone (757) 892-4265

113 Gainsborough Sq
Ste 101
Chesapeake, VA 23320
Phone (757) 436-3285

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

844 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6746

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

3241 Western Branch Blvd
Ste A
Chesapeake, VA 23321

541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700

3009 Corporate Ln
Ste 220
Suffolk, VA 23434
Phone 7574836100 ext. 208

2000 Meade Pkwy
Suffolk, VA 23434
Phone (757) 539-0251

2000 Meade Pkwy
Ste 195
Suffolk, VA 23434

5839 Harbour View Blvd
Ste 200
Suffolk, VA 23435
Phone (757) 483-6100

100 Sentara Cir
Williamsburg, VA 23188
Phone (678) 690-7826

Interoperability endpoints

  • FHIR API: https://b9dda605-4d4e-4319-b477-73b223ba7709.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 8

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": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503360000000",
    "number": "1578986287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 BRENNHAVEN TRAL",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23323",
            "telephone_number": "520-331-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "address_2": "ANESTHESIA DEPT",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082197",
            "telephone_number": "757-953-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ANDY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-31",
        "last_updated": "2017-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "716685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2017; 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.