NPIMap

Individual provider Active NPI

Wesley A Soutar, DNP CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1629806716
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4024782 Issued in KY
Practice address
530 S Jackson St
Louisville, KY 40202-1675
Phone
(502) 852-1735
NPI assigned
Jul 22, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 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 AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X 4024782 KY Primary

Addresses

Primary practice location

530 S Jackson St
Louisville, KY 40202-1675

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0328

Other practice location 1

1903 W Hebron Ln
Shepherdsville, KY 40165-7425
Phone (502) 955-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241114004163 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456885367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

530 S Jackson St
Louisville, KY 40202-1675
Phone (502) 562-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4024782KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. Multi-Specialty CurrentSince Oct 1, 2024 Accepting new patients
University of Louisville Physicians, Inc. Multi-Specialty Current Accepting new patients
University of Louisville Phyisicians, Inc. Multi-Specialty CurrentSince Oct 1, 2024 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

1903 W Hebron Ln
Shepherdsvlle, KY 40165
Phone (502) 587-4421

Organizations & group practices 3

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 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1629806716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S JACKSON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021675",
            "telephone_number": "502-852-1735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1903 W Hebron Ln",
            "address_purpose": "LOCATION",
            "city": "Shepherdsville",
            "state": "KY",
            "postal_code": "401657425",
            "country_code": "US",
            "telephone_number": "502-955-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTAR",
        "first_name": "WESLEY",
        "middle_name": "A",
        "credential": "DNP CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "4024782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.