Keith Maxwell Bull, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

101335 Issued in NE

Practice address

2300 E 30TH St
Building a
Farmington, NM 87401-8990

Phone

(505) 326-6400

NPI assigned

Feb 25, 2016

Last updated

Apr 27, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM, WY2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Four Corners Anesthesia, P.a.Group PAC ID 6608762950, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.64 of 100Reported as group

Quality

78.78

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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.

• Four Corners Anesthesia, P.a.

  • Anesthesiology Physician
  • Farmington, NM
  • NPI 1093758831
  Medicare reassignment Care Compare group
• Frontier Anesthesia LLC

  • Anesthesiologist Assistant
  • Cheyenne, WY
  • NPI 1568815843
  Medicare reassignment

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1851751432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E 20TH ST",
            "address_2": "SUITE A",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874019039",
            "telephone_number": "505-326-6400",
            "fax_number": "505-326-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST",
            "address_2": "BUILDING A",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018990",
            "telephone_number": "505-326-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULL",
        "first_name": "KEITH",
        "middle_name": "MAXWELL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-25",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "101335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140943",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55278710",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryce J. Hunter, D.C. P.C.
• Charisse Buchanan, AG-NP-C
• Wendy K Buchanan
• Anna Victoria Buck, FNP
• Eric Buffington
• Nicole Bunner, LSAA
• Chris T. Buntrock, M.D.
• Ruth Adele Burd, PT
• Anita Christine Burge, FNP-BC
• Clarissa Burgess

• Certified Registered Nurse Anesthetist in Farmington, NM
• Providers in Farmington, NM by specialty
• Certified Registered Nurse Anesthetist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.