Individual provider Active NPI

Tara Lewis, CRNA

  • Certified Registered Nurse Anesthetist
  • Harlan, KY
National Provider Identifier
1902045206
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
47146 Issued in KY
Practice address
81 Ball Park Rd
Harlan, KY 40831-1701
Phone
(606) 573-8100
NPI assigned
Feb 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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 47146 KY Primary

Addresses

Primary practice location

81 Ball Park Rd
Harlan, KY 40831-1701

Mailing address

3320 Tates Creek Rd
204
Lexington, KY 40502-3400
Phone (859) 268-1030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090526000242 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668521550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triangle Anesthesia Group, PSCGroup PAC ID 9436161585, 77 clinicians

Practice addresses (Care Compare)

100 Medical Ctr Dr
Hazard, KY 41701-9421
Phone (606) 439-6600

Hospital & facility affiliations

  • Harlan Arh Hospital Hospital, Harlan, KY, CCN 180050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47146KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Triangle Anesthesia Group PSC Nurse Anesthetist, Certified Registered CurrentSince Apr 11, 2009 Accepting new patients

Locations

81 Ball Park Rd
Harlan, KY 40831
Phone (606) 573-8100

100 Medical Dr
Hazard, KY 41701
Phone (606) 439-6600

425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322

260 Hospital Dr
South Williamson, KY 41503
Phone (606) 237-1700

Organizations & group practices 1

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": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1902045206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 TATES CREEK RD",
            "address_2": "204",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405023400",
            "telephone_number": "859-268-1030",
            "fax_number": "859-269-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 BALL PARK RD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408311701",
            "telephone_number": "606-573-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "TARA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-10",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "47146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.