Melissa Anne Cogdell, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Kokomo, IN
NPI 1003411604 · NPPES record last updated Feb 24, 2025
Key facts
- NPI
- 1003411604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 214344 (AR)
- Practice address
- 1907 W Sycamore St
Kokomo, IN 46901-5148 - Phone
- (765) 456-5433
- NPI assigned
- Dec 1, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. Joseph Primary Care, LLC
Practice addresses (Care Compare)
1907 W Sycamore St
Kokomo, IN 46901-5148
Phone (765) 456-5433
Hospital & facility affiliations
- Ascension St Vincent Kokomo
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR, IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210309002775 | AR | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9739595109 | Reassigns benefits to 1 organization |
| I20250117000747 | IN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9739595109 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph Primary Care, LLC | Current |
Accepting new patients | |
| St. Joseph Primary LLC | Current |
Accepting new patients | |
| Jonesboro Anesthesia Inc | Current |
Accepting new patients |
Locations
1100 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-8500
225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630
250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331
3109 W Sycamore St
Kokomo, IN 46901
Phone (765) 457-1191
1907 W Sycamore St
Kokomo, IN 46901
Phone (765) 452-5611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | TX | ||
| Certified Registered Nurse Anesthetist | 367500000X | 214344 | AR | Yes |
Addresses
Primary practice location
1907 W Sycamore St
Kokomo, IN 46901-5148
Mailing address
1907 W Sycamore St
Kokomo, IN 46901-5148
Other practice location 1
505 E Matthews Ave Ste 303
Jonesboro, AR 72401-3101
Phone (870) 932-4211
Other providers in Kokomo, IN
- Braysha Cobb
- Audrey Cochran
- Jennifer Cochran
- Maci Coffin
- Jess Coffman
- Melissa Dawn Cohee
- Hillary Cole
- Kyle Jacob Coleman
- Melissa Coleman
- Taylor Coleman
All providers in Kokomo, IN · Certified Registered Nurse Anesthetist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.