| Keith W Green, CRNA | |
|
800 W 9th St, Jasper, IN 47546-2514 | |
| (812) 482-0643 | |
| (812) 482-0214 |
| Full Name | Keith W Green |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 28 Years |
| Location | 800 W 9th St, Jasper, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508920653 | NPI | - | NPPES |
| 200157750A | Medicaid | IN | |
| 28138655 | Other | IN | INDIANA LICENSE |
| 940070020 | Other | IN | MEDICARE PTAN |
| 000000211953 | Other | IN | ANTHEM BC ID |
| 163460047 | Other | IN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 9261695 (Florida) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 28138655A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Indiana University Health | Indianapolis, IN | Hospital |
| Indiana University Health Bedford Hospital | Bedford, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Indiana University Health Inc | 2365350675 | 68 |
| Indiana University Health Bedford Inc | 2668383092 | 6 |
| Entity Name | Indiana University Health Bedford Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871036962 PECOS PAC ID: 2668383092 Enrollment ID: O20031122000022 |
| Entity Name | Indiana University Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376586719 PECOS PAC ID: 2365350675 Enrollment ID: O20040407000695 |
| Entity Name | Indiana University Health Paoli Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457519324 PECOS PAC ID: 2668426016 Enrollment ID: O20050308001174 |
| Entity Name | Anesthesia Care Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073899449 PECOS PAC ID: 6608042288 Enrollment ID: O20120103000455 |
| Entity Name | Apollo Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396179461 PECOS PAC ID: 3072741370 Enrollment ID: O20140113001443 |
| Entity Name | Anesthesia Dynamics Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073001012 PECOS PAC ID: 3779832530 Enrollment ID: O20191011000052 |
| Entity Name | Ivory Coast Anesthesia Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083484000 PECOS PAC ID: 4880039676 Enrollment ID: O20240304000400 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith W Green, CRNA 2061 W Skyview Dr, Jasper, IN 47546-8214 Ph: (812) 634-9504 | Keith W Green, CRNA 800 W 9th St, Jasper, IN 47546-2514 Ph: (812) 482-0643 |
Mrs. Meghan Elizabeth Buchta, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 W 9th St, Jasper, IN 47546 Phone: 812-996-2345 | |
Lori Leeds, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 800 W 9th St, Jasper, IN 47546 Phone: 812-996-2345 | |
Mariah Spayd, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 800 W 9th St, Jasper, IN 47546 Phone: 812-996-2345 | |
Adam Keith Thomas, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 W 9th St, Jasper, IN 47546 Phone: 812-996-2345 | |
Angela Joy Weinzapfel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 600 W 13th St, Suite 100, Jasper, IN 47546 Phone: 812-483-2228 | |
Stephanie Flick, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 W 9th St, Jasper, IN 47546 Phone: 812-482-0643 Fax: 812-482-0214 | |
Claire E Edwards, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 W 9th St, Jasper, IN 47546 Phone: 812-996-2345 |