NPIMap

Organization Active NPI

Providian Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1821654666
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PROVIDIAN ANESTHESIA LLC
Practice address
1169 Eastern Pkwy Ste 400
Louisville, KY 40217-1412
Phone
(502) 276-5554
NPI assigned
May 16, 2019
Last updated
May 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Authorized official

Name
Mr. Denis J Beiter, CRNANPI 1922036565
Title
Member
Phone
(502) 472-5020

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

1169 Eastern Pkwy Ste 400
Louisville, KY 40217-1412

Mailing address

12468 La Grange Rd Ste 342
Louisville, KY 40245-1901
Phone (502) 472-5020

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190614000874 KY Part B Supplier - Clinic/Group Practice 2264765791 Receives reassigned benefits from 45 practitioners
Practice locations: Hurstbourne, KY; Louisville, KY
O20210210002466 IN Part B Supplier - Clinic/Group Practice 2264765791 Receives reassigned benefits from 11 practitioners
Practice locations: Evansville, IN

National Provider Directory

National Provider Directory

Locations

7145 E Virginia St
Ste 4000
Evansville, IN 47715
Phone (812) 476-6166

279 Kings Daughters Dr
Ste 100
Frankfort, KY 40601
Phone (502) 352-9354

2700 Old Rosebud Rd
Ste 350
Lexington, KY 40509
Phone (502) 290-7246

1169 Eastern Pkwy
Ste 400
Louisville, KY 40217
Phone (502) 276-5554

2944 Breckenridge Ln
Louisville, KY 40220
Phone (502) 995-5525

4111 Oechsli Ave
Louisville, KY 40207
Phone (502) 576-6918

4203 Springhurst Blvd
Louisville, KY 40241
Phone (502) 290-7246

Practitioners & affiliated clinicians

Practitioners 50

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 50

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1821654666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12468 LA GRANGE RD STE 342",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402451901",
            "telephone_number": "502-472-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY STE 400",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171412",
            "telephone_number": "502-276-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDIAN ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "BEITER",
        "authorized_official_first_name": "DENIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "502-472-5020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.