Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1154549061
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
12661 FOXWOOD PT
POPLAR BLUFF, MO 639017745
Phone: (573) 686-7622
Type: Mailing
1201 FIRST ST
KENNETT, MO 63857
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 11 Open Payments records for all available years, with a total value of $777.
Total Amount is formed as General ($777) + Research ($0) + Ownership ($0) = $777.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($404).
Total Amount
$777
General + Research + Ownership
Payments
11
Total payment records
General Amount
$777
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pacira Pharmaceuticals Incorporated | $404 |
| Stryker Corporation | $234 |
| Avanos Medical | $92 |
| Becton, Dickinson and Company | $48 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 32 | 22 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 25 | 25 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 18 | 14 | $0 |
Insurance plans in this area (ZIP 63901)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CERTIFIED REGISTERED NURSE ANESTHET | MO | 00142 | Anesthesia for lens surgery | 38 | 37 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Radiation Oncology | FL | |
| Cardiovascular Disease (Cardiology) | MO | |
| Family Practice, Undersea And Hyperbaric Medicine | TX | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | MO | |
| P S Y C H I A T R Y | TX | |
| - | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| - | MO | |
| Physician Assistant | MO |
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