JOHN M RICKETTS (CRNA) – Certified Registered Nurse Anesthetist, NPI 1053520874
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,775 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MO
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Provider Addresses for JOHN M RICKETTS (CRNA)
209, South Main Street, Poplar Bluff, Butler County, Missouri, 63901, United States
POPLAR BLUFF, MO 639015831
Phone: (573) 686-5550
Fax: (573) 686-2139
Type: Mailing
1231, 1st Street, Kennett, Dunklin County, Missouri, 63857, United States
KENNETT, MO 638572527
Phone: (573) 888-4522
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $29.
Total Amount is formed as General ($29) + Research ($0) + Ownership ($0) = $29.
Last reported payment date: 2024-03-04 • Largest payer in this snapshot: ABBVIE INC. ($29).
Total Amount
$29
General + Research + Ownership
Payments
1
Total payment records
General Amount
$29
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $29 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-10-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041015000627 | I | Certified Registered Nurse Anesthetist (Crna) | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63901)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| Emergency Medicine | MO | |
| U R O L O G Y | TN | |
| - | KY | |
| Family Practice | GA | |
| Nurse Practitioner | MO | |
| General Surgery | TN | |
| P O D I A T R Y | TN | |
| Certified Registered Nurse Anesthetist (Crna) | AR | |
| - | MO |
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