Organization Active NPI

Excellent Professional Anes., PLLC

  • Certified Registered Nurse Anesthetist
  • Murray, KY
National Provider Identifier
1649568312
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
EXCELLENT PROFESSIONAL ANES., PLLC
Practice address
803 Poplar St
Murray, KY 42071-2432
Phone
(270) 762-1104
NPI assigned
Jul 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Authorized official

Name
Ernest P Ayo, CRNANPI 1487650115
Title
Owner
Phone
(270) 362-9480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

803 Poplar St
Murray, KY 42071-2432

Mailing address

659 Sherwood Dr
Gilbertsville, KY 42044-8666
Phone (270) 362-9480

Other identifiers 1

IdentifierTypeStateIssuer
74008046MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1649568312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 SHERWOOD DR",
            "city": "GILBERTSVILLE",
            "state": "KY",
            "postal_code": "420448666",
            "telephone_number": "270-362-9480",
            "fax_number": "574-268-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 POPLAR ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712432",
            "telephone_number": "270-762-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENT PROFESSIONAL ANES., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-15",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "AYO",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-362-9480",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74008046",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.