Individual provider Active NPI

Kevin Anthony Trankle, CRNA

  • Certified Registered Nurse Anesthetist
  • Jesup, GA
National Provider Identifier
1922081173
Registry record updated Jan 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN068870 Issued in GA
Practice address
865 S 1St St
Jesup, GA 31545-0210
Phone
(706) 660-8505
Fax
(706) 660-9390
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2012

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 RN068870 GA Primary

Addresses

Primary practice location

865 S 1St St
Jesup, GA 31545-0210

Mailing address

PO Box 2585
Columbus, GA 31902-2585
Phone (706) 660-8505

Other identifiers 1

IdentifierTypeStateIssuer
000793493AMedicaidGA

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
RN068870GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Nmda Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Sentry Anesthesia Management, LLC PastSince Jan 2, 2020 Accepting new patients
Hospital Authority of Wayne County Georgia Nurse Anesthetist, Certified Registered Past Accepting new patients
South Atlanta Vascular Institute, LLC Past Accepting new patients
Quiescence Anesthesia LLC Nurse Anesthetist, Certified Registered PastSince Oct 1, 2021 Accepting new patients
Hospital Authority of Wayne County Georgia Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18188/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/BIJACD

Organizations & group practices 6

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327708800000",
    "number": "1922081173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2585",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319022585",
            "telephone_number": "706-660-8505",
            "fax_number": "706-660-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 S 1ST ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450210",
            "telephone_number": "706-660-8505",
            "fax_number": "706-660-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRANKLE",
        "first_name": "KEVIN",
        "middle_name": "ANTHONY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2012-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN068870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000793493A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

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