NPIMap

Organization Active NPI

Central Kentucky Anesthesia P.S.C.

  • Certified Registered Nurse Anesthetist
  • Lexington, KY
National Provider Identifier
1851474159
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1329545 Issued in KY
Legal business name
CENTRAL KENTUCKY ANESTHESIA P.S.C.
Practice address
1740 Nicholasville Rd
Lexington, KY 40503-1431
Phone
(859) 260-6100
NPI assigned
Oct 23, 2006
Last updated
May 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Authorized official

Name
Dr. Thomas Broster, M.D.NPI 1053496331
Title
President
Phone
(859) 268-1030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1329545 KY Primary

Addresses

Primary practice location

1740 Nicholasville Rd
Lexington, KY 40503-1431

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
1329545OtherKYUMWA
7100191870MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031115000040 KY Part B Supplier - Clinic/Group Practice 4880508712 Receives reassigned benefits from 109 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lexington, KY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Central Kentucky Anesthesia2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1800 Nicholasville Rd
Ste 104
Lexington, KY 40503
Phone (859) 276-1557

Practitioners & affiliated clinicians

Practitioners 128

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 128

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1851474159",
    "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": "1740 NICHOLASVILLE RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031431",
            "telephone_number": "859-260-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL KENTUCKY ANESTHESIA P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "BROSTER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-268-1030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1329545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1329545",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100191870",
            "state": "KY"
        }
    ],
    "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 May 21, 2013; 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.