Jo E Wilburn, CRNA

Key facts

NPI

1891796348

Entity type

Individual (NPI type 1)

Primary specialty

Certified Registered Nurse Anesthetist 367500000X

License

1718A (KY)

Practice address

4000 Kresge Way
Louisville, KY 40207-4605

Phone

(502) 259-5391

Fax

(502) 259-9733

NPI assigned

Aug 9, 2005

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Anesthesiology Associates PSC Anesthesiology Physician · Louisville, KY · NPI 1164400701
  NPD (past) NURSE ANESTHETIST, CERTIFIED REGISTERED
• One Anesthesia PLLC Anesthesiology Physician · Louisville, KY · NPI 1174513246
  NPD (past) NURSE ANESTHETIST, CERTIFIED REGISTERED
• U S Anesthesia Partners of Kentucky PSC Anesthesiology Physician · Louisville, KY · NPI 1144901042
  NPD (past) NURSE ANESTHETIST, CERTIFIED REGISTERED

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Certified Registered Nurse

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 16, 2012.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1891796348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34748",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402324748",
            "telephone_number": "502-259-5391",
            "fax_number": "502-259-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 KRESGE WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074605",
            "telephone_number": "502-259-5391",
            "fax_number": "502-259-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBURN",
        "first_name": "JO",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1718A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74428913",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003500A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

• Laura Conrad Wilbanks, M.D.
• Charles Zachary Wilbert, APRN
• Fred Marsh Wilbur, D.M.D.
• Victoria Elaine Wilbur
• Brent Manning Wilburn
• Sarah Elizabeth Wilburn, LCSW
• Cherie Finley Wilcher, FNP
• Olivia Wildeman, OTR/L
• Riley Patrick Wildemann, PHARMD, BCCP
• Wilder Physical Therapy, Inc.

All providers in Louisville, KY · Certified Registered Nurse Anesthetist in Kentucky