Active NPI
Elliott Schwartz, CRNA
- Certified Registered Nurse Anesthetist
- Hazard, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN071875
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 641757270C | Medicaid | GA | |
| 876338120A | Medicaid | GA | |
| 641757270B | Medicaid | GA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 42233 | KY | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Georgia Anesthesia LLC | Current | Accepting new patients | |
| Ams Southeast LLC | Nurse Anesthetist, Certified Registered | Current | 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.
-
- Anesthesiology Physician
- Pensacola, FL
- NPI 1487107157
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Waycross, GA
- NPI 1265518849
-
- Home Health Agency
- Moultrie, GA
- NPI 1558375840
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.