KELLY ANN BOCK (CRNA) – Certified Registered Nurse Anesthetist, NPI 1104480219

KELLY ANN BOCK (CRNA) is a healthcare provider. based in Joplin, Missouri. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 2019019657 (MO). The NPI Number for KELLY ANN BOCK (CRNA) is 1104480219

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
KELLY ANN BOCK (CRNA)
NPI
1104480219
Phone
(417) 347-6605
Address
PO BOX 3810
Enumeration Date
24 April 2019
Last Update Date
11 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4172696000
Graduation Year
2019 (7 years ago)
PAC ID
7113252339
Group Practice PAC ID
1850290149
Professional Enrollment ID
I20190710003062
Address ID
MO658075210SP3801XAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,775 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MO

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Provider Addresses for KELLY ANN BOCK (CRNA)

  • PO BOX 3810

    JOPLIN, MO 648033810

    Phone: (417) 347-6605

    Type: Mailing

  • 1102, West 32nd Street, Joplin, Newton County, Missouri, 64804, United States

    JOPLIN, MO 648043503

    Phone: (417) 347-1111

    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 $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2024-04-06 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-07-10

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190710003062ICertified Registered Nurse Anesthetist (Crna)MOTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00300Anesthesia for other procedure on skin, muscles, or nerves of head, neck, and upper back1313$0
View full utilization report →

Insurance plans in this area (ZIP 64803)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850290149View full group profile
NameSpecialtyState
Anesthesiology AssistantMO
Certified Registered Nurse Anesthetist (Crna)MO
-MO
Certified Registered Nurse Anesthetist (Crna)MO
A N E S T H E S I O L O G YMO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
Anesthesiology AssistantMO
Anesthesiology AssistantMO
-MO

Reviews

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Frequently asked questions

How do I look up KELLY ANN BOCK (CRNA) by NPI?
Use NPI 1104480219 when you need to reference KELLY ANN BOCK (CRNA) in forms, claims, or directories.
Is KELLY ANN BOCK (CRNA) currently active in the NPI registry?
CMS-published data lists KELLY ANN BOCK (CRNA) as an active registrant.
What kind of provider is KELLY ANN BOCK (CRNA)?
The page reflects Certified Registered Nurse Anesthetist for KELLY ANN BOCK (CRNA). Clinical services aligned with this taxonomy classification.
What location shows for KELLY ANN BOCK (CRNA)?
We surface Joplin, Missouri for KELLY ANN BOCK (CRNA) based on available NPPES addresses.
Is KELLY ANN BOCK (CRNA) a real provider?
This page reflects official NPPES data for NPI 1104480219. Always confirm identity and privileges with the practice and licensing boards.

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