Individual provider Active NPI

Elliott Schwartz, CRNA

  • Certified Registered Nurse Anesthetist
  • Hazard, KY
National Provider Identifier
1699722017
Registry record updated Nov 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN071875 Issued in GA
Practice address
100 Medical Center Dr
Hazard, KY 41701-9421
Phone
(606) 439-6600
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2008

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 42233 KY
Certified Registered Nurse Anesthetist 367500000X RN071875 GA Primary

Addresses

Primary practice location

100 Medical Center Dr
Hazard, KY 41701-9421

Mailing address

3320 Tates Creek Rd
Suite 204
Lexington, KY 40502-3400
Phone (859) 268-1030

Other identifiers 3

IdentifierTypeStateIssuer
641757270CMedicaidGA
876338120AMedicaidGA
641757270BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42233KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Georgia Anesthesia LLC CurrentSince May 1, 2008 Accepting new patients
Ams Southeast LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 23, 2018 Accepting new patients
Colquitt Regional Health Incorporated Past Accepting new patients

Locations

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

410 Darling Ave
Waycross, GA 31501
Phone (912) 283-3030

2003 Alice St
Ste 2003B
Waycross, GA 31501
Phone (912) 490-3338

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227657600000",
    "number": "1699722017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 TATES CREEK RD",
            "address_2": "SUITE 204",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405023400",
            "telephone_number": "859-268-1030",
            "fax_number": "859-269-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019421",
            "telephone_number": "606-439-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "ELLIOTT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2008-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "42233",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN071875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "641757270C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876338120A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "641757270B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; 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.