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SUNDANCE ZXAINE KEMP CAA NPI 1679233118


NPI Information

NPI: 1679233118
Provider Name: SUNDANCE ZXAINE KEMP, CAA
Classification: Anesthesiologist Assistant - 367H00000X
Entity Type: Individual
Address:
2401 W UNIVERSITY AVE
MUNCIE, IN
ZIP 47303
Phone: (765) 747-3111
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Sundance Zxaine Kemp, CAA is an anesthesiologist assistant in Muncie, IN with 3 years of experience. The provider is an individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. Sundance Zxaine Kemp, CAA NPI is 1679233118. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2401 W UNIVERSITY AVE
MUNCIE, IN
ZIP 47303-499
Phone: (765) 747-3111

The enumeration date for this NPI number is 12/25/2021 and was last updated on 8/29/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1367H00000XAnesthesiologist AssistantTL95SOUTH CAROLINANo
2367H00000XAnesthesiologist AssistantNo
3367H00000XAnesthesiologist Assistant75000098AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1M22404254OTHERINDIANAMEDICARE PTAN
2PENDINGMEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.