Individual provider Active NPI

Kristen Kae Carlson-McCarthy, CRNA

  • Certified Registered Nurse Anesthetist
  • Lacona, IA
National Provider Identifier
1699854877
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D-073435 Issued in IA
Practice address
20955 S23 Hwy
Lacona, IA 50139-8861
Phone
(515) 229-3393
NPI assigned
Nov 6, 2006
Last updated
Nov 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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 D-073435 IA Primary

Addresses

Primary practice location

20955 S23 Hwy
Lacona, IA 50139-8861

Mailing address

20955 S23 Hwy
Lacona, IA 50139-8861

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519001074 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820039837 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D-073435IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne County Hospital Current Accepting new patients
Clarke County Public Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Knoxville Area Anesthesia Services Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

417 S East St
Corydon, IA 50060
Phone (641) 872-2260

Interoperability endpoints

  • Direct secure messaging: kcarlsonmccarthy3941311@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1699854877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20955 S23 HWY",
            "city": "LACONA",
            "state": "IA",
            "postal_code": "501398861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20955 S23 HWY",
            "city": "LACONA",
            "state": "IA",
            "postal_code": "501398861",
            "telephone_number": "515-229-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON-MCCARTHY",
        "first_name": "KRISTEN",
        "middle_name": "KAE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D-073435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacona, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.