Individual provider Active NPI

Sandra Keddy, CRNA

  • Certified Registered Nurse Anesthetist
  • Concord, NH
National Provider Identifier
1639572647
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
039078-23 Issued in NH
Practice address
1 Pillsbury St
Concord, NH 03301-3556
Phone
(603) 224-4776
NPI assigned
Oct 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 039078-21 NH
Certified Registered Nurse Anesthetist 367500000X 039078-23 NH Primary

Addresses

Primary practice location

1 Pillsbury St
Concord, NH 03301-3556

Mailing address

4 Greensboro Rd
Hanover, NH 03755-3100
Phone (864) 505-2454

Other identifiers 1

IdentifierTypeStateIssuer
3100822MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150326000090 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416274725 Reassigns benefits to 4 organizations
I20230315000998 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416274725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-2325

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039078-21NHMDRegistered Nurse
039078-23NHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Littleton Hospital Association CurrentSince Aug 26, 2019 Accepting new patients
Littleton Hospital Association CurrentSince Aug 26, 2019 Accepting new patients
Mission Health Community Multispecialty Providers, LLC Anesthesiology CurrentSince Apr 10, 2023 Accepting new patients
Anesthesia Care Group PC Anesthesiology CurrentSince Apr 1, 2018 Accepting new patients
Medstream Anesthesia PLLC Anesthesiology CurrentSince Sep 10, 2018 Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince Apr 10, 2023 Accepting new patients
Anesthesia Associates Professional Association Anesthesiology CurrentSince Jan 15, 2015 Accepting new patients

Locations

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

1 Pillsbury St
Concord, NH 03301
Phone (603) 223-2300

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

600 Saint Johnsbury Rd
Littleton, NH 03561
Phone (603) 444-9000

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

88 McGregor St
Ste 303
Manchester, NH 03102
Phone (603) 647-9325

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 7

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": "1412380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1639572647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GREENSBORO RD",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037553100",
            "telephone_number": "864-505-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PILLSBURY ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013556",
            "telephone_number": "603-224-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEDDY",
        "first_name": "SANDRA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-04",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "039078-21",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "039078-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3100822",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.