Individual provider Active NPI

Pamela Kennedy, CRNA

  • Certified Registered Nurse Anesthetist
  • Cincinnati, OH
National Provider Identifier
1629061627
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
126547 Issued in OH
Practice address
2000 Joseph E. Sanker Boulevard
The Urology Center
Cincinnati, OH 45212
Phone
(513) 841-7600
Fax
(513) 841-7601
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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 126547 OH Primary

Addresses

Primary practice location

2000 Joseph E. Sanker Boulevard
The Urology Center
Cincinnati, OH 45212

Mailing address

4549 Raynor Court
Outpatient Anesthesia Specialists
Mason, OH 45040
Phone (513) 204-5696

Other identifiers 1

IdentifierTypeStateIssuer
0756472MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080104000398 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335229244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
126547OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri State Urologic Services PSC Inc Current Accepting new patients
Perioperative Medical Consutants Inc Past Accepting new patients

Locations

2000 Joseph E Sanker Blvd
Norwood, OH 45212
Phone (513) 841-7400

Organizations & group practices 2

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1629061627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4549 RAYNOR COURT",
            "address_2": "OUTPATIENT ANESTHESIA SPECIALISTS",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "513-204-5696",
            "fax_number": "877-284-4283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 JOSEPH E. SANKER BOULEVARD",
            "address_2": "THE UROLOGY CENTER",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45212",
            "telephone_number": "513-841-7600",
            "fax_number": "513-841-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "PAMELA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "126547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0756472",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.