Carl Robert Davis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209012907 Issued in IL

Practice address

2 Good Samaritan Way
Suite 205
Mount Vernon, IL 62864-2408

Phone

(618) 241-1108

Fax

(618) 241-3805

NPI assigned

Jul 2, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apex Anesthesia Partners PLLCGroup PAC ID 3476891656, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Apex Anesthesia Partners, PLLC

  • Anesthesiology Physician
  • Paducah, KY
  • NPI 1902373772

  KY, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia of Kentucky, PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1386938900

  KY, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Nguyen Chiropractic LLC

  • Chiropractor
  • Smyrna, GA
  • NPI 1730425786
  NPD (past)
• The Roeske Clinic, PC

  • Neurology Chiropractor
  • Smyrna, GA
  • NPI 1720200116
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1992188338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4227 LINCOLNSHIRE DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642157",
            "telephone_number": "618-241-1108",
            "fax_number": "618-241-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 GOOD SAMARITAN WAY",
            "address_2": "SUITE 205",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642408",
            "telephone_number": "618-241-1108",
            "fax_number": "618-241-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CARL",
        "middle_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209012907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Nanette Dalmasso, LPN
• Ashley Daniels, FNP
• Chirag Dave, M.D.
• David J. Lane, LTD.
• Alicia Davis
• Dennon W Davis, M.D.
• Duane Allen Davis, D.M.D.
• Heather Dawn Davis, APRN,FNP-C
• Jason A Davison, NP-C
• Deaconess Illinois Clinic, Inc

• All providers in Mount Vernon, IL
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.