Monica Blackburn, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Edgewood, KY
NPI 1679558167 · NPPES record last updated Aug 28, 2012
Key facts
- NPI
- 1679558167
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 1047367 (KY)
- Practice address
- 1 Medical Village Dr
Independent Anesthesiologists PSC
Edgewood, KY 41017-3403 - Phone
- (859) 341-7246
- Fax
- (859) 341-7867
- NPI assigned
- Dec 7, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1047367 | KY | MD | Certified Registered Nurse Anesthetist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1047367 | KY | Yes |
Addresses
Primary practice location
1 Medical Village Dr
Independent Anesthesiologists PSC
Edgewood, KY 41017-3403
Mailing address
20 Medical Village Drive #258
Independent Anesthesiologists PSC
Edgewood, KY 41017
Phone (859) 341-7246
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000288565 | Other | BLUE SHIELD | |
| 200416410 | Medicaid | IN | |
| 74476144 | Medicaid | KY | |
| 2380963 | Medicaid | OH |
Other providers in Edgewood, KY
- Karissa Sheree Bird
- Peter Arthur Birmingham II
- Lauren Nicole Bischof
- Stephanie Marie Bishop
- Suzanne M Black
- William Joseph Blackburn
- Amy Jo Blair
- Julie Blair
- Flynn Charles Blanchet
- Kristie L Blanchet
All providers in Edgewood, KY · Certified Registered Nurse Anesthetist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.