Individual provider Active NPI

Judith A McKee, CRNA

  • Certified Registered Nurse Anesthetist
  • Lake Havasu City, AZ
National Provider Identifier
1871557603
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
012144 Issued in AZ
Practice address
40 Capri Blvd
Ste 102
Lake Havasu City, AZ 86403-5661
Phone
(928) 855-9477
NPI assigned
Apr 17, 2006
Last updated
Mar 6, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 012144 AZ Primary

Addresses

Primary practice location

40 Capri Blvd
Ste 102
Lake Havasu City, AZ 86403-5661

Mailing address

40 Capri Blvd
Ste 102
Lake Havasu City, AZ 86403-5661
Phone (928) 855-9477

Other identifiers 2

IdentifierTypeStateIssuer
AZ0308020OtherAZBCBS AZ
936643MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
012144AZMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Providers of East Texas, PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Limestone County Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Anderson County Anesthesia Associates, PA Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1871557603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CAPRI BLVD",
            "address_2": "STE 102",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035661",
            "telephone_number": "928-855-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CAPRI BLVD",
            "address_2": "STE 102",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035661",
            "telephone_number": "928-855-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "012144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AZ",
            "identifier": "AZ0308020",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "936643",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.