Individual provider Active NPI

Myrna Borders, CRNA

  • Certified Registered Nurse Anesthetist
  • Madisonville, KY
National Provider Identifier
1962509596
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4705A Issued in KY
Practice address
900 Hospital Dr
Madisonville, KY 42431-1644
Phone
(270) 825-5100
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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 4705A KY Primary

Addresses

Primary practice location

900 Hospital Dr
Madisonville, KY 42431-1644

Mailing address

200 Clinic Dr
Madisonville, KY 42431-1661

Other identifiers 3

IdentifierTypeStateIssuer
000000374836OtherBCBS PROVIDER NUMBER
74010794MedicaidKY
4705AOtherKYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141017001640 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002835477 Reassigns benefits to 2 organizations
I20210125001653 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002835477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Baldwin Anesthesia PCGroup PAC ID 8022262864, 23 clinicians

Practice addresses (Care Compare)

1613 N McKenzie St
Foley, AL 36535-2247
Phone (334) 279-1450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4705AKYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
BMR Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 11, 2021 Accepting new patients
South Baldwin Anesthesia, PC CurrentSince Aug 11, 2014 Accepting new patients

Locations

135 Medical Park Dr
Ste 2B
Andalusia, AL 36420
Phone (850) 753-8075

1613 N McKenzie St
Foley, AL 36535
Phone (251) 949-3400

855 Downtowner Blvd
Mobile, AL 36609

1851 N 9th Ave
Ste B
Pensacola, FL 32503
Phone (850) 479-4223

5102 N Davis Hwy
Pensacola, FL 32503
Phone (850) 484-8800

400 10th St E
Waconia, MN 55387

Organizations & group practices 2

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1962509596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HOSPITAL DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311644",
            "telephone_number": "270-825-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDERS",
        "first_name": "MYRNA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "4705A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "000000374836",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74010794",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4705A",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.