Individual provider Active NPI

A Kathleen Nelson, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
National Provider Identifier
1881685212
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP 1454572 Issued in FL
Practice address
3949 Evans Ave
Ste 102
Fort Myers, FL 33901-9335
Phone
(239) 939-2622
Fax
(239) 939-0151
NPI assigned
Nov 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 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 ARNP 1454572 FL Primary

Addresses

Primary practice location

3949 Evans Ave
Ste 102
Fort Myers, FL 33901-9335

Mailing address

3949 Evans Ave
Ste 102
Fort Myers, FL 33901-9335
Phone (239) 939-2622

Other identifiers 1

IdentifierTypeStateIssuer
G0616OtherBCBS

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

State licenses

LicenseStateTypeSpecialty
ARNP 1454572FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesia Past Accepting new patients
First Anesthesia Associates Inc Past Accepting new patients
Collier Anesthesia PA Past Accepting new patients
Outpatient Anesthesia of Southwest Florida Inc PastSince Jan 1, 2013 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1881685212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 EVANS AVE",
            "address_2": "STE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019335",
            "telephone_number": "239-939-2622",
            "fax_number": "239-939-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 EVANS AVE",
            "address_2": "STE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019335",
            "telephone_number": "239-939-2622",
            "fax_number": "239-939-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "A",
        "middle_name": "KATHLEEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP 1454572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G0616",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.