Individual provider Active NPI

Rosalie Spreen Gray, CRNA

  • Certified Registered Nurse Anesthetist
  • Shelbyville, KY
National Provider Identifier
1962466144
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3005392 Issued in KY
Practice address
727 Hospital Dr
Shelbyville, KY 40065-1660
Phone
(502) 647-4085
Fax
(502) 647-4098
NPI assigned
Apr 14, 2006
Last updated
Jul 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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 C00606 AR
Certified Registered Nurse Anesthetist 367500000X 3005392 KY Primary

Addresses

Primary practice location

727 Hospital Dr
Shelbyville, KY 40065-1660

Mailing address

100 E Liberty St Ste 800
Louisville, KY 40202-1428

Other practice location 1

1850 Bluegrass Ave
Louisville, KY 40215-1161
Phone (502) 367-3360

Other practice location 2

727 Hospital Dr
Shelbyville, KY 40065
Phone (502) 647-4085

Other practice location 3

4305 New Shepherdsville Rd
Anesthesia Department
Bardstown, KY 40004-9019
Phone (502) 350-5032

Other practice location 4

4305 New Shepherdsville Rd
Anesthesia Department
Bardstown, KY 40004-9019
Phone (502) 350-5032

Other identifiers 3

IdentifierTypeStateIssuer
50053842OtherKYPASSPORT-SME
7100041770MedicaidKY
P01922699RROtherKYRR MEDICARE

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
C00606ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Services LTD Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Bluegrass Anesthesia Services, PSC Nurse Anesthetist, Certified Registered Past Accepting new patients
Sleepers Anesthesia Services, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Care Enterprises, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1962466144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST STE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 HOSPITAL DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651660",
            "telephone_number": "502-647-4085",
            "fax_number": "502-647-4098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 Bluegrass Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402151161",
            "country_code": "US",
            "telephone_number": "502-367-3360",
            "fax_number": "502-367-3365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "727 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "KY",
            "postal_code": "40065",
            "country_code": "US",
            "telephone_number": "502-647-4085",
            "fax_number": "502-647-4098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4305 New Shepherdsville Rd",
            "address_2": "Anesthesia Department",
            "address_purpose": "LOCATION",
            "city": "Bardstown",
            "state": "KY",
            "postal_code": "400049019",
            "country_code": "US",
            "telephone_number": "502-350-5032",
            "fax_number": "502-350-5022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4305 New Shepherdsville Rd",
            "address_2": "Anesthesia Department",
            "address_purpose": "LOCATION",
            "city": "Bardstown",
            "state": "KY",
            "postal_code": "400049019",
            "country_code": "US",
            "telephone_number": "502-350-5032",
            "fax_number": "502-350-5022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ROSALIE",
        "middle_name": "SPREEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C00606",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3005392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT-SME",
            "identifier": "50053842",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100041770",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01922699RR",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.