NPIMap

Individual provider Active NPI

Thomas H Kelchlin, CRNA

  • Certified Registered Nurse Anesthetist
  • Albuquerque, NM
National Provider Identifier
1609869205
Registry record updated Oct 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA00953 Issued in NM
Practice address
4401 Masthead St NE
Suite 120
Albuquerque, NM 87109-4327
Phone
(505) 243-7729
Fax
(505) 243-4804
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2013

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 CRNA00953 NM Primary

Addresses

Primary practice location

4401 Masthead St NE
Suite 120
Albuquerque, NM 87109-4327

Mailing address

4401 Masthead St NE
Suite 120
Albuquerque, NM 87109-4327
Phone (505) 243-7729

Other identifiers 1

IdentifierTypeStateIssuer
67108261MedicaidNM

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
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
CRNA00953NMMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort County Memorial Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Specialists of Albuquerque Past Accepting new patients
Memorial Health Anesthetists Past Accepting new patients
Parkside Medical Anesthesia Associates Nurse Anesthetist, Certified Registered Past Accepting new patients
Wallace Thomson Hospital Past Accepting new patients
Eye Health Associates of Western New York PC Past Accepting new patients
Spartanburg Hospital for Restorative Care Past Accepting new patients
Beaufort County Memorial Hospital Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1609869205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 MASTHEAD ST NE",
            "address_2": "SUITE 120",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094327",
            "telephone_number": "505-243-7729",
            "fax_number": "505-243-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 MASTHEAD ST NE",
            "address_2": "SUITE 120",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094327",
            "telephone_number": "505-243-7729",
            "fax_number": "505-243-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELCHLIN",
        "first_name": "THOMAS",
        "middle_name": "H",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA00953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67108261",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.