Individual provider Active NPI

Mary Schlautman, CRNA

  • Certified Registered Nurse Anesthetist
  • Fremont, NE
National Provider Identifier
1063581585
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
100908 Issued in NE
Practice address
300 E 23Rd St
Fremont, NE 68025-2302
Phone
(402) 727-7990
Fax
(402) 727-1761
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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 100908 NE Primary

Addresses

Primary practice location

300 E 23Rd St
Fremont, NE 68025-2302

Mailing address

2828 Brooks Hollow Dr
Fremont, NE 68025-3681
Phone (402) 720-8296

Other identifiers 1

IdentifierTypeStateIssuer
911765978-15MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050207000682 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810948841 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leighow Anesthesia & Medical Aesthetics LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 29, 2022 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients
Associated Anesthesiologists PC PastSince Feb 25, 2024 Accepting new patients

Locations

2727 N Clarkson St
Fremont, NE 68025
Phone (402) 727-8500

11606 Nicholas St
Omaha, NE 68154
Phone (402) 493-2020

Interoperability endpoints

  • Direct secure messaging: mary.schlautman@direct.nmhs.org

Organizations & group practices 5

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1063581585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 BROOKS HOLLOW DR",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680253681",
            "telephone_number": "402-720-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252302",
            "telephone_number": "402-727-7990",
            "fax_number": "402-727-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLAUTMAN",
        "first_name": "MARY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "100908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "911765978-15",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.