Kenneth A Ebert, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

28128216A Issued in IN

Practice address

1500 S Lake Park Ave
Hobart, IN 46342-6638

Phone

(219) 947-6695

Fax

(219) 947-6092

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• American Anesthesiology of Illinois, LLC

  • Anesthesiology Physician
  • Merrillville, IN
  • NPI 1326224270
  NPD (past)
• Methodist Anesthesia, LLC

  • Anesthesiology Physician
  • Merrillville, IN
  • NPI 1821045410

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Allied Anesthesia Associates, P.C.

  • Interventional Pain Medicine Physician
  • Joliet, IL
  • NPI 1750330742
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1619928058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S LAKE PARK AVE",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426638",
            "telephone_number": "219-947-6695",
            "fax_number": "219-947-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S LAKE PARK AVE",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426638",
            "telephone_number": "219-947-6695",
            "fax_number": "219-947-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "KENNETH",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28128216A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200097770",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Doolin
• Dungarvin Indiana, LLC
• Lachanda Leann Dunlap-Wright
• Leslie Rita Durbin, CLC
• Cayce East-Figaro, MOTR/L
• Obi Echeumuna
• Emily Edmond
• Edgardo Laher Eliscupides, RPT
• Epmg of Indiana, PC
• Kristin Patrice Erdei, LCSW

• Certified Registered Nurse Anesthetist in Hobart, IN
• Providers in Hobart, IN by specialty
• Certified Registered Nurse Anesthetist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.