Individual provider Active NPI

Derek Robert Whaley, CRNA

  • Certified Registered Nurse Anesthetist
  • Lexington, KY
National Provider Identifier
1770057416
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3012993 Issued in KY
Practice address
310 S Limestone
Lexington, KY 40508-3008
Phone
(859) 268-1030
Fax
(859) 269-4120
NPI assigned
Jan 16, 2019
Last updated
Jan 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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 3012993 KY Primary

Addresses

Primary practice location

310 S Limestone
Lexington, KY 40508-3008

Mailing address

425 Lewis Hargett Cir
Lexington, KY 40503-3590
Phone (859) 268-1030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190305002571 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608115852 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1740 Nicholasville Rd
Lexington, KY 40503-1431
Phone (859) 268-1030

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3012993KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered CurrentSince Feb 11, 2019 Accepting new patients
Central Kentucky Anesthesia PSC CurrentSince Jan 1, 2022 Accepting new patients
Central Kentucky Anesthesia P.S.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
Anesthesia Associates, PSC Nurse Anesthetist, Certified Registered CurrentSince Feb 11, 2019 Accepting new patients

Locations

1 Saint Joseph Dr
Lexington, KY 40504
Phone (502) 350-5000

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

1720 Nicholasville Rd
Lexington, KY 40503
Phone (859) 277-2211

1740 Nicholasville Rd
Lexington, KY 40503
Phone (859) 260-6100

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322

Interoperability endpoints

  • Direct secure messaging: dwhaley25163@ukhcdirect.org

Organizations & group practices 4

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 1

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": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1770057416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 LEWIS HARGETT CIR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033590",
            "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": "310 S LIMESTONE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405083008",
            "telephone_number": "859-268-1030",
            "fax_number": "859-269-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "DEREK",
        "middle_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3012993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.