Individual provider Active NPI

Casey Lane Truitt, RN, BSN, CCRN

  • Registered Nurse
  • Joplin, MO
National Provider Identifier
1023637071
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2015020712 Issued in MO
Practice address
100 Mercy Way
Joplin, MO 64804-4524
Phone
(417) 556-3729
NPI assigned
Apr 9, 2020
Last updated
Apr 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2015020712 MO Primary

Addresses

Primary practice location

100 Mercy Way
Joplin, MO 64804-4524

Mailing address

6202 W Buckeye Dr
Rogers, AR 72758-6050
Phone (417) 861-5866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230107000036 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365812302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastro Anesthesia PLLCGroup PAC ID 3577727700, 6 clinicians

Practice addresses (Care Compare)

3344 N Futrall Dr
Fayetteville, AR 72703-4057
Phone (479) 582-7280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
2015020712MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Anesthesia PLLC CurrentSince Aug 11, 2022 Accepting new patients

Locations

3700 SE Dodson Rd
Ste 4
Bentonville, AR 72712
Phone (479) 308-4300

3344 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 582-7213

405 N University Ave
Little Rock, AR 72205
Phone (501) 228-4445

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1023637071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6202 W BUCKEYE DR",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727586050",
            "telephone_number": "417-861-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-556-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUITT",
        "first_name": "CASEY",
        "middle_name": "LANE",
        "name_prefix": "Mr.",
        "credential": "RN, BSN, CCRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2015020712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.