Individual provider Active NPI

Kenneth Glover

  • Certified Registered Nurse Anesthetist
  • Winchester, VA
National Provider Identifier
1700284593
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024172271 Issued in VA
Practice address
1840 Amherst St
Winchester, VA 22601-2808
Phone
(540) 536-8000
NPI assigned
Dec 11, 2014
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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 78421 WV
Certified Registered Nurse Anesthetist 367500000X 0024172271 VA Primary

Addresses

Primary practice location

1840 Amherst St
Winchester, VA 22601-2808

Mailing address

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150316002156 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072830819 Reassigns benefits to 4 organizations
I20190812003299 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072830819 Reassigns benefits to 2 organizations

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
Group practices
Jefferson Memorial HospitalGroup PAC ID 0446151989, 33 clinicians

Practice addresses (Care Compare)

300 S Preston St
Ranson, WV 25438-1631
Phone (304) 728-1669

500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone (757) 594-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024172271VAMDCertified Registered Nurse Anesthetist
78421WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince Feb 1, 2015 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Dec 17, 2021 Accepting new patients
Jefferson Memorial Hospital CurrentSince Jul 19, 2019 Accepting new patients
Jefferson Memorial Hospital CurrentSince Jul 19, 2019 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Dec 17, 2021 Accepting new patients
Shenandoah Valley Pathology Laboratories Inc Current Accepting new patients
SMG Anesthesia Specialists LLC CurrentSince Nov 8, 2021 Accepting new patients
Winchester Medical Center Current Accepting new patients
Winchester Anesthesiologists Inc CurrentSince Jun 12, 2017 Accepting new patients
Winchester Medical Center Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2015 Accepting new patients
Jefferson Memorial Hospital Current Accepting new patients

Locations

500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000

1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

500 J Clyde Morris Blvd
North North, VA 23601
Phone (757) 594-2000

2800 Godwin Blvd
Suffolk, VA 23434
Phone (757) 934-4000

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

1860 Amherst St
Winchester, VA 22601
Phone (540) 536-7870

874 Fox Dr
Winchester, VA 22603
Phone (540) 662-0990

878 Fox Dr
Winchester, VA 22603
Phone (540) 546-2624

300 S Preston St
Ranson, WV 25438
Phone (304) 728-1600

Organizations & group practices 11

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1700284593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012808",
            "telephone_number": "540-536-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012808",
            "telephone_number": "540-536-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-11",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "78421",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024172271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.

Verify at the official NPI Registry.