KGC Crna LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP 9217913 Issued in FL

Legal business name

KGC CRNA LLC

Practice address

3337 Cappio Dr
Melbourne, FL 32940-1313

Phone

(321) 759-4460

NPI assigned

Jun 21, 2013

Organization subpart

No

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

Authorized official

Name

Kandee Georgette Coppala, CRNANPI 1174637383

Title

Manager/Owner

Phone

(321) 759-4460

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kandee G Coppala, CRNA

  • Certified Registered Nurse Anesthetist
  • Melbourne, FL
  • NPI 1174637383
  Medicare reassignment Authorized official
• Bradley D. Kuehn, M.D.

  • Anesthesiology Physician
  • Sunrise, FL
  • NPI 1225024466
  Medicare reassignment NPD

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374192000000",
    "number": "1609215730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 410580",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329410580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3337 CAPPIO DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401313",
            "telephone_number": "321-759-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KGC CRNA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-21",
        "last_updated": "2013-07-19",
        "status": "A",
        "authorized_official_last_name": "COPPALA",
        "authorized_official_first_name": "KANDEE",
        "authorized_official_middle_name": "GEORGETTE",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "321-759-4460",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP 9217913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306690800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Key
• Carol Friebolin Keydel, PH.D, MSW
• William C Keyes, DMD
• Keystone Clinical Diagnostic LLC
• Keystone Mental Health
• Kha Duong OD PA
• Kha Duong PLLC
• Nagwa Khadr, M.D.
• Khan Biosurgical Tech PA
• Saba Khan, D.O.

• Certified Registered Nurse Anesthetist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.