Larry D Phipps, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

54086 Issued in KS

Practice address

1400 W 4TH St
Coffeyville, KS 67337-3306

Phone

(620) 252-1200

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Anesthesiology Physician
  • Jonesboro, AR
  • NPI 1992036032
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1043288913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9863 N SPRING VALLEY RD",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369735",
            "telephone_number": "620-423-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W 4TH ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373306",
            "telephone_number": "620-252-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1902 S US Highway 59",
            "address_purpose": "LOCATION",
            "city": "Parsons",
            "state": "KS",
            "postal_code": "673574948",
            "country_code": "US",
            "telephone_number": "620-421-4880",
            "fax_number": "316-652-0340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "LARRY",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C001304",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "54086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100246250B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430073196",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200017590A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "043406",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Allen Patrzykont, D.D.S.
• Peer Medical Imaging Interpretation LLC
• Peter McKinley Peer II, DO
• Michelle B Perry, APRN
• Barry Curtis Phillips, N.P.-C
• PHS KS Moirai LLC
• PHS KS Moirai LLC
• Carrie Ann Pitts
• Plaza Pharmacy Inc
• Heather Lee Pollet, APRN

• Certified Registered Nurse Anesthetist in Coffeyville, KS
• Providers in Coffeyville, KS by specialty
• Certified Registered Nurse Anesthetist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.