Martin J Kelly, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C002728 Issued in AR

Practice address

2710 Rife Medical LN
Rogers, AR 72758-1452

Phone

(913) 642-4900

Fax

(913) 381-0979

NPI assigned

Dec 18, 2007

Last updated

Nov 7, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Renew Medical Group of Arkansas LTD

  • Anesthesiology Physician
  • Fort Smith, AR
  • NPI 1215755947

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Services of Benton County PA

  • Anesthesiology Physician
  • Rogers, AR
  • NPI 1013084482
  Medicare reassignment NPD
• Western Arkansas Anesthesiology Associates P.a.

  • Anesthesiology Physician
  • Fort Smith, AR
  • NPI 1548202294
  Medicare reassignment NPD
• Youngs Professional Services LLC

  dba YPS Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  AR, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Deaconess Hospital, Inc

  dba Deaconess Care Group

  • Hospitalist Physician
  • Evansville, IN
  • NPI 1427097443
  NPD
• U S Anesthesia Partners of Kentucky PSC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1144901042

  Nurse Anesthetist, Certified Registered

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Rogers

  dba Mercy Hospital Northwest Arkansas

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1851575476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 507",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450507",
            "telephone_number": "913-642-4900",
            "fax_number": "913-381-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "913-642-4900",
            "fax_number": "913-381-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARTIN",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-18",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C002728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176438001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "P00849069",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5V105",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "604337200",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Keene, LMFT
• Abby Keener, DC
• Kaylee Keener, PA-C
• Keever Pediatrics PA
• Craig Keever, MD
• Shannon Marie Kelly, RN
• Brandon B. Kemp, CRNA
• Ken Berley, D.D.S., LTD.
• Sarah Jane Kennard
• Amanda Marie Kennedy, APRN

• Certified Registered Nurse Anesthetist in Rogers, AR
• Providers in Rogers, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.