NPIMap

Individual provider Active NPI

Renal R Miller, CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1639566862
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3011573 Issued in KY
Practice address
11401 Gosling Shoals Way
Louisville, KY 40229-6515
Phone
(847) 274-3367
NPI assigned
Apr 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209.013201 IL
Certified Registered Nurse Anesthetist 367500000X 3011573 KY Primary

Addresses

Primary practice location

11401 Gosling Shoals Way
Louisville, KY 40229-6515

Mailing address

11401 Gosling Shoals Way
Louisville, KY 40229-6515
Phone (847) 274-3367

Other identifiers 2

IdentifierTypeStateIssuer
300006480MedicaidIN
7100499950MedicaidKY

Other names 1

  • Renal R. Nallatan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170818002267 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315248663 Reassigns benefits to 3 organizations
I20200605000537 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315248663

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians
Universal Anesthesia Services LLCGroup PAC ID 9830268341, 58 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 629-8000

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • Baptist Health Louisville Hospital, Louisville, KY, CCN 180130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209.013201ILMDCertified Registered Nurse Anesthetist
3011573KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2021 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Dec 7, 2020 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Dec 7, 2020 Accepting new patients
Professional Anesthesia Services of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2018 Accepting new patients

Locations

3423 Solutions Ctr
Chicago, IL 60677

7752 Solution Ctr
Chicago, IL 60677

200 Missouri Ave
Jeffersonvlle, IN 47130
Phone (812) 920-0055

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

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

4960 Norton Healthcare Blvd
Louisville, KY 40241
Phone (502) 446-8000

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 5

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1430006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1639566862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 GOSLING SHOALS WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402296515",
            "telephone_number": "847-274-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 GOSLING SHOALS WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402296515",
            "telephone_number": "847-274-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RENAL",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-26",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.013201",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3011573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300006480",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100499950",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENAL",
            "last_name": "NALLATAN",
            "middle_name": "R.",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 9, 2020; 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.