Individual provider Active NPI

George D Kendall, CRNA, MSN

  • Certified Registered Nurse Anesthetist
  • Bedford, IN
National Provider Identifier
1881687705
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28200961 Issued in IN
Practice address
2900 W 16TH Street
Bedford, IN 47421-3510
Phone
(812) 275-1200
Fax
(812) 275-1212
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN-240448 OH
Certified Registered Nurse Anesthetist 367500000X 28200961 IN Primary

Addresses

Primary practice location

2900 W 16TH Street
Bedford, IN 47421-3510

Mailing address

PO Box 12
Bedford, IN 47421-3510
Phone (740) 380-8068

Other identifiers 2

IdentifierTypeStateIssuer
28200961OtherINRN
2397973MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160229001936 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577692946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Anesthesia Associates, IncGroup PAC ID 0648170365, 54 clinicians

Practice addresses (Care Compare)

610 W Main St
Wilmington, OH 45177-2125
Phone (937) 382-6611

Hospital & facility affiliations

  • Wayne Hospital Hospital, Greenville, OH, CCN 361335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
47609TXMDPharmacist
RN-240448OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists of Fort Wayne PC Nurse Anesthetist, Certified Registered CurrentSince Mar 14, 2016 Accepting new patients
Hocking Valley Medical Group, Inc. Current Accepting new patients
Anesthesia Providers of East Texas, PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Anderson County Anesthesia Associates, PA Past Accepting new patients

Locations

10315 Dawsons Creek Blvd
Ste Ab
Fort Wayne, IN 46825
Phone (219) 436-7875

121 Westfield Dr
Archbold, OH 43502
Phone (419) 445-2015

601 State Route 664 N
Logan, OH 43138
Phone (740) 380-8000

819 State Route 664 N
Logan, OH 43138
Phone (740) 380-8140

Interoperability endpoints

  • Direct secure messaging: gkendall@yourcarecommunity.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1881687705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213510",
            "telephone_number": "740-380-8068",
            "fax_number": "740-380-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W 16TH STREET",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213510",
            "telephone_number": "812-275-1200",
            "fax_number": "812-275-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "GEORGE",
        "middle_name": "D",
        "credential": "CRNA, MSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN-240448",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28200961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "28200961",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2397973",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.