Individual provider Active NPI

Robert Blake Capps

  • Certified Registered Nurse Anesthetist
  • Paducah, KY
National Provider Identifier
1770927956
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3008420 Issued in KY
Practice address
225 Medical Center Dr
Suite 405
Paducah, KY 42003-7914
Phone
(270) 441-4750
Fax
(270) 441-4770
NPI assigned
Apr 18, 2013
Last updated
Aug 27, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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 3008420 KY Primary
Registered Nurse 163W00000X RN0000161355 TN

Addresses

Primary practice location

225 Medical Center Dr
Suite 405
Paducah, KY 42003-7914

Mailing address

225 Medical Center Dr
Suite 405
Paducah, KY 42003-7914
Phone (270) 441-4750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201117002444 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890934665 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin Anesthesia Group IncGroup PAC ID 1951384619, 3 clinicians
Dr. Mark Armstrong MD PCGroup PAC ID 2365494119, 3 clinicians

Practice addresses (Care Compare)

161 Mount Pelia Rd
Martin, TN 38237-3811
Phone (731) 588-0001

1722 E Reelfoot Ave
Suite 1
Union City, TN 38261-6050
Phone (731) 885-0085

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN0000161355TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Mark Armstrong MD PC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients
Martin Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients
Kentenn Anesthesia Nurse Anesthetist, Certified Registered CurrentSince May 13, 2021 Accepting new patients

Locations

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

1109 E Reelfoot Ave
Ste C
Union City, TN 38261
Phone (731) 884-0600

1722 E Reelfoot Ave
Ste 1
Union City, TN 38261
Phone (731) 885-0085

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.

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": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1770927956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DR",
            "address_2": "SUITE 405",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037914",
            "telephone_number": "270-441-4750",
            "fax_number": "270-441-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DR",
            "address_2": "SUITE 405",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037914",
            "telephone_number": "270-441-4750",
            "fax_number": "270-441-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPS",
        "first_name": "ROBERT",
        "middle_name": "BLAKE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-18",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3008420",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000161355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.