Active NPI
Kelly Ann Trout, CRNA
- Certified Registered Nurse Anesthetist
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 649236
- Practice address
- 34800 Bob Wilson Dr
San Diego, CA 92134-1098 - Phone
- (619) 532-6400
- NPI assigned
- Dec 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 649236 | CA | Primary |
Addresses
Primary practice location
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Mailing address
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone (619) 532-6400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
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
Practice addresses (Care Compare)
1333 E Barnett Rd
Medford, OR 97504-8219
Phone (541) 858-4000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 649236 | CA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospitalist Medicine Physicians of Washington - TCS | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Trout Anesthesia | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
400 10th St E
Waconia, MN 55387
1333 E Barnett Rd
Medford, OR 97504
Phone (541) 779-4711
9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234
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.
-
- Certified Registered Nurse Anesthetist
- Medford, OR
- NPI 1457075608
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Portland, OR
- NPI 1649816380
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419897600000",
"number": "1659769552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921341098",
"telephone_number": "619-532-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921341098",
"telephone_number": "619-532-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TROUT",
"first_name": "KELLY",
"middle_name": "ANN",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-30",
"last_updated": "2014-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "649236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.