Individual provider Active NPI

Krystal Kirby Glover, CRNA

  • Certified Registered Nurse Anesthetist
  • Raleigh, NC
National Provider Identifier
1619084498
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2124 Issued in NC
Practice address
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone
(919) 784-3034
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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 2124 NC Primary

Addresses

Primary practice location

4420 Lake Boone TRL
Raleigh, NC 27607-7505

Mailing address

3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880
Phone (919) 873-9533

Other identifiers 2

IdentifierTypeStateIssuer
8052377MedicaidNC
P00281345OtherNCRAILROAD-MEDICARE

Other names 1

  • Krystal D Kirby Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109000760 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416975321 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Sedation Associates LLCGroup PAC ID 1254698624, 21 clinicians
American Anesthesiology of North Carolina PLLCGroup PAC ID 2961316450, 315 clinicians

Practice addresses (Care Compare)

2417 Atrium Dr
Suite 101
Raleigh, NC 27607-6673
Phone (919) 249-5216

4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (919) 873-9533

Hospital & facility affiliations

  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2124NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC CurrentSince Sep 19, 2005 Accepting new patients
Raleigh Sedation Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2024 Accepting new patients
Rsa Johnston LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 30, 2024 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 19, 2005 Accepting new patients
Johnston Health Endoscopy Services, LLC Past Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1500 Concord Ter
Fl 5
Sunrise, FL 33323
Phone (954) 384-0175

2417 Atrium Dr
Ste 101
Raleigh, NC 27607
Phone (919) 249-5216

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

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.

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1619084498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SPRING FOREST RD",
            "address_2": "SUITE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162880",
            "telephone_number": "919-873-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077505",
            "telephone_number": "919-784-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "KRYSTAL",
        "middle_name": "KIRBY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "2124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052377",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD-MEDICARE",
            "identifier": "P00281345",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "KIRBY",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.