Individual provider Active NPI

Richard C Dore', RN, CRNA

  • Certified Registered Nurse Anesthetist
  • Farmington, MO
National Provider Identifier
1003860370
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
111287 Issued in MO
Practice address
1212 Weber Rd
Farmington, MO 63640-3325
Phone
(573) 756-4581
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 111287 MO Primary

Addresses

Primary practice location

1212 Weber Rd
Farmington, MO 63640-3325

Mailing address

908 Green Briar Dr
Farmington, MO 63640-7160
Phone (573) 756-4581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060117000383 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416971536 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ste Genevieve County Memorial HospitalGroup PAC ID 3274432802, 74 clinicians

Practice addresses (Care Compare)

800 Genevieve Dr
Ste Genevieve, MO 63670-1434
Phone (573) 883-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Aug 30, 2021 Accepting new patients
Physician Groups LC Past Accepting new patients

Locations

1101 W Liberty St
Farmington, MO 63640
Phone (573) 705-1272

1101 W Liberty St
#97
Farmington, MO 63640

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1003860370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 GREEN BRIAR DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636407160",
            "telephone_number": "573-756-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 WEBER RD",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636403325",
            "telephone_number": "573-756-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORE'",
        "first_name": "RICHARD",
        "middle_name": "C",
        "credential": "RN, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "111287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.