Active NPI
Robert Blake Capps
- Certified Registered Nurse Anesthetist
- Paducah, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 3008420
- 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, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
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.
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN0000161355 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Mark Armstrong MD PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Martin Anesthesia Group Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Kentenn Anesthesia | Nurse Anesthetist, Certified Registered | Current | 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.
-
- Anesthesiology Physician
- Union City, TN
- NPI 1144357799
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Martin, TN
- NPI 1326107327
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Union City, TN
- NPI 1346511011
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba West Tennessee Healthcare Volunteer Hospital
- General Acute Care Hospital
- Martin, TN
- NPI 1275505372
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.