| Travis L Smith, CRNA | |
|
1373 E State Road 62, Madison, IN 47250-7328 | |
| (812) 801-0609 | |
| (812) 801-0276 |
| Full Name | Travis L Smith |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 24 Years |
| Location | 1373 E State Road 62, Madison, 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 |
|---|---|---|---|
| 1215914445 | NPI | - | NPPES |
| 200946180 | Medicaid | IN | |
| 74009473 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 3004523 (Kentucky) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Southern Ohio Medical Center | Portsmouth, OH | Hospital |
| Wakemed, Raleigh Campus | Raleigh, NC | Hospital |
| Carolinas Medical Center/behav Health | Charlotte, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| East Carolina Anesthesia Associates Pllc | 5092720813 | 578 |
| Chs Anesthesia Services Group Inc | 5799007324 | 633 |
| Somc Medical Care Foundation, Inc. | 9436061645 | 264 |
| Entity Name | Wake Forest University Health Sciences |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003803032 PECOS PAC ID: 4486564952 Enrollment ID: O20031105000436 |
| Entity Name | American Anesthesiology Of North Carolina Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053677195 PECOS PAC ID: 2961316450 Enrollment ID: O20031229000004 |
| Entity Name | East Carolina Anesthesia Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205996519 PECOS PAC ID: 5092720813 Enrollment ID: O20060215000791 |
| Entity Name | Chs Anesthesia Services Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346649415 PECOS PAC ID: 5799007324 Enrollment ID: O20141209001856 |
| Entity Name | Triad Sedation Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427528595 PECOS PAC ID: 4587903448 Enrollment ID: O20190312000286 |
| Mailing Address | Practice Location Address |
|---|---|
| Travis L Smith, CRNA Dept 86236, Po Box 950195, Louisville, KY 40295-0195 Ph: (502) 473-2100 | Travis L Smith, CRNA 1373 E State Road 62, Madison, IN 47250-7328 Ph: (812) 801-0609 |
Kenneth L Harding Jr., C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1373 E State Road 62, Madison, IN 47250 Phone: 812-801-0156 Fax: 812-801-0276 |