NPIMap

Organization Active NPI

Resource Anesthesia Cumberland Valley Inc

  • Certified Registered Nurse Anesthetist
  • Corbin, KY
National Provider Identifier
1780930743
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
RESOURCE ANESTHESIA CUMBERLAND VALLEY INC
Practice address
275 Hwy 770
Corbin, KY 40701-4736
Phone
(606) 526-7874
Fax
(865) 777-0910
NPI assigned
Jul 27, 2012
Last updated
Feb 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Authorized official

Name
Mr. Phillip Kent Haynie, CRNANPI 1841287224
Title
President
Phone
(865) 777-0909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

275 Hwy 770
Corbin, KY 40701-4736

Mailing address

12752 Kingston Pike
Suite E202
Knoxville, TN 37934-0948
Phone (865) 777-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121102000100 KY Part B Supplier - Clinic/Group Practice 2961652755 Receives reassigned benefits from 43 practitioners
Practice locations: Albany, KY; Berea, KY; Bowling Green, KY; Corbin, KY; Hazard, KY; Lexington, KY
O20210816003883 IN Part B Supplier - Clinic/Group Practice 2961652755 Receives reassigned benefits from 6 practitioners
Practice locations: Evansville, IN

National Provider Directory

National Provider Directory
Tax ID family
Resource Anesthesia Cumberland Valley Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7145 E Virginia St
Ste 100
Evansville, IN 47715
Phone (812) 476-6166

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1780930743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12752 KINGSTON PIKE",
            "address_2": "SUITE E202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379340948",
            "telephone_number": "865-777-0909",
            "fax_number": "865-777-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 HWY 770",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407014736",
            "telephone_number": "606-526-7874",
            "fax_number": "865-777-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESOURCE ANESTHESIA CUMBERLAND VALLEY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "HAYNIE",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-777-0909",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.