Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin W Boog, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1306160023

Kevin W Boog, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Providence, Rhode Island. Qualified in 2009, 17 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
17
Licensed in
RI
In the registry since
2010
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

593 Eddy Street Davol 129
Providence, RI 02903-4923
Phone: (401) 444-4933
Fax: (401) 444-5090
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 101 Dudley St, Providence, RI 02905-2401 — (401) 453-7950

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence RNA36713 (RI)

Record details

NPI number1306160023
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedMarch 24, 2010
Last updated in NPPESDecember 22, 2022
Certification dateDecember 22, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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