Individual provider Active NPI

Timothy J Guernsey

  • Certified Registered Nurse Anesthetist
  • Bridgeton, MO
National Provider Identifier
1063052918
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2019045630 Issued in MO
Practice address
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone
(314) 344-6000
NPI assigned
Jan 8, 2020
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2019045630 MO Primary
Certified Registered Nurse Anesthetist 367500000X 209031792 IL

Addresses

Primary practice location

12303 De Paul Dr
Bridgeton, MO 63044-2512

Mailing address

400 S Woods Mill Rd Ste 140
Chesterfield, MO 63017-3427
Phone (314) 485-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200214001915 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062848831 Reassigns benefits to 2 organizations
I20251110000797 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062848831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians
Missouri Baptist Medical CenterGroup PAC ID 3476461955, 123 clinicians

Practice addresses (Care Compare)

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209031792ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro-West Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2020 Accepting new patients
Missouri Baptist Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jan 27, 2024 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Sep 29, 2025 Accepting new patients
Mid-West Anesthesia Partners, LLC CurrentSince Dec 7, 2025 Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

400 S Woods Mill Rd
Ste 140
Chesterfield, MO 63017
Phone (314) 485-1101

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1063052918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S WOODS MILL RD STE 140",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173427",
            "telephone_number": "314-485-1101",
            "fax_number": "314-485-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442512",
            "telephone_number": "314-344-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERNSEY",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-08",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2019045630",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209031792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.