Individual provider Active NPI

Ginger Renee Waldron, MSN

  • Certified Registered Nurse Anesthetist
  • Madisonville, KY
National Provider Identifier
1659550069
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
5335A Issued in KY
Practice address
900 Hospital Dr
Madisonville, KY 42431-1653
Phone
(270) 825-5100
NPI assigned
Nov 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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 Anesthetist 367500000X 5335A KY Primary

Addresses

Primary practice location

900 Hospital Dr
Madisonville, KY 42431-1653

Mailing address

900 Hospital Dr
Madisonville, KY 42431-1653
Phone (270) 825-5100

Other identifiers 2

IdentifierTypeStateIssuer
7100024780MedicaidKY
5335AOtherKYLICENSE

Other names 1

  • Ginger Renee Holloman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071121000372 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234227471 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Conoloway Anesthesia PLLCGroup PAC ID 9133590201, 6 clinicians

Practice addresses (Care Compare)

910 Wallace Ave
Leitchfield, KY 42754-2414
Phone (270) 259-9400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
5335AKYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Conoloway Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2022 Accepting new patients
Professional Anesthesia Services of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients

Locations

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035

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

Organizations & group practices 2

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 2

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": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1659550069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HOSPITAL DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311653",
            "telephone_number": "270-825-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HOSPITAL DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311653",
            "telephone_number": "270-825-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "GINGER",
        "middle_name": "RENEE",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "5335A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100024780",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5335A",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINGER",
            "last_name": "HOLLOMAN",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madisonville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.