Individual provider Active NPI

Devan Marie Keane, CRNA

  • Certified Registered Nurse Anesthetist
  • Gainesville, FL
National Provider Identifier
1730554528
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9324638 Issued in FL
Practice address
4131 NW 13TH St Ste 101
Gainesville, FL 32609-1858
Phone
(352) 376-1887
NPI assigned
Dec 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9324638 FL
Certified Registered Nurse Anesthetist 367500000X ARNP9324638 FL Primary

Addresses

Primary practice location

4131 NW 13TH St Ste 101
Gainesville, FL 32609-1858

Mailing address

4131 NW 13TH St Ste 101
Gainesville, FL 32609-1858
Phone (352) 376-1887

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171005000845 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739486150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Street Anesthesia of New Mexico, LLCGroup PAC ID 3476807538, 228 clinicians

Practice addresses (Care Compare)

601 Dr Martin Luther King Jr Ave NE
Lovelace Medical Center
Albuquerque, NM 87102-3619
Phone (505) 727-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9324638FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Anesthesia of New Mexico, LLC CurrentSince Jan 1, 2019 Accepting new patients
Simedhealth LLC Past Accepting new patients

Locations

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

Organizations & group practices 2

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": "1449273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1730554528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 NW 13TH ST STE 101",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326091858",
            "telephone_number": "352-376-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 NW 13TH ST STE 101",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326091858",
            "telephone_number": "352-376-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANE",
        "first_name": "DEVAN",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-05",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9324638",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9324638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.