NPIMap

Individual provider Active NPI

John Roussel, CRNA

  • Certified Registered Nurse Anesthetist
  • New Albany, IN
National Provider Identifier
1659365658
Registry record updated Nov 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
47452 Issued in KY
Practice address
3605 Northgate CT
Ste 101
New Albany, IN 47150-6400
Phone
(812) 944-4263
Fax
(812) 944-1166
NPI assigned
Sep 6, 2005
Last updated
Nov 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2014

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 47452 KY Primary
Registered Nurse 163W00000X 28152575A IN

Addresses

Primary practice location

3605 Northgate CT
Ste 101
New Albany, IN 47150-6400

Mailing address

6601 Arbor Ridge Dr
Crestwood, KY 40014-7745
Phone (502) 931-9962

Other identifiers 1

IdentifierTypeStateIssuer
200363700MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040131000316 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628971066 Reassigns benefits to 4 organizations
I20070906000400 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628971066 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Georgetown University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Universal Anesthesia Services LLCGroup PAC ID 9830268341, 58 clinicians
Louisville Anesthesia Provision LLCGroup PAC ID 2567533839, 23 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 629-2880

4004 Dupont Cir
Louisville, KY 40207-4819
Phone (502) 896-6428

520 W 1St St
Louisville Anesthesia Provision
New Albany, IN 47150-3603
Phone (812) 949-3442

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28152575AINMDRegistered Nurse
47452KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgery Center of New Albany, LLC Current Accepting new patients
Apollo Medical Group of Jeffersonville LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2021 Accepting new patients
Universal Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 3, 2016 Accepting new patients
Sda Consultants PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 3, 2025 Accepting new patients
Anesthesiology Consultants Enterprises, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2026 Accepting new patients
Louisville Anesthesia Provision LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2025 Accepting new patients
Eye Surgery Center of New Albany, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 4, 2021 Accepting new patients
Providian Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2021 Accepting new patients
Lec Ancillary PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2016 Accepting new patients
Professional Anesthesia Services of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 4, 2025 Accepting new patients
Louisville Endoscopy Center, PLLC PastSince May 1, 2016 Accepting new patients
Kleinert Kutz and Associates Hand Care Center Past Accepting new patients
Wabash Valley Anesthesia Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3423 Solutions Ctr
Chicago, IL 60677

3135 Middle Rd
Columbus, IN 47203
Phone (812) 373-7777

500 Arcade Ave
Ste 100
Elkhart, IN 46514
Phone (574) 389-5683

200 Missouri Ave
Bldg 18
Jeffersonvlle, IN 47130
Phone (502) 552-5221

2990 Gottbrath Pkwy
Jeffersonvlle, IN 47130
Phone (812) 670-0990

520 W 1st St
New Albany, IN 47150
Phone (812) 949-3442

2000 Tunnel Hill Rd
Elizabethtown, KY 42701
Phone (270) 304-2520

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

1400 Poplar Level Rd
Ste 2
Louisville, KY 40217
Phone (502) 452-9567

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

4004 DuPont Cir
Louisville, KY 40207
Phone (502) 896-6428

444 S 1st St
Ste 202
Louisville, KY 40202
Phone (502) 238-2888

9202 Leesgate Rd
Louisville, KY 40222
Phone (502) 276-5554

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416009600000",
    "number": "1659365658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 ARBOR RIDGE DR",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400147745",
            "telephone_number": "502-931-9962",
            "fax_number": "502-561-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 NORTHGATE CT",
            "address_2": "STE 101",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471506400",
            "telephone_number": "812-944-4263",
            "fax_number": "812-944-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSEL",
        "first_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2014-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "47452",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28152575A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200363700",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2014; 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.