Individual provider Active NPI

Scott Fankhauser, CRNA

  • Certified Registered Nurse Anesthetist
  • Shawnee Mission, KS
National Provider Identifier
1073390431
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
558242 Issued in KS
Practice address
9100 W 74TH St
Shawnee Mission, KS 66204-4004
Phone
(913) 632-2230
Fax
(913) 632-2297
NPI assigned
Sep 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X WV
Registered Nurse 163W00000X 111002 WV
Certified Registered Nurse Anesthetist 367500000X 558242 KS Primary

Addresses

Primary practice location

9100 W 74TH St
Shawnee Mission, KS 66204-4004

Mailing address

PO Box 411895
Kansas City, MO 64141-1895
Phone (913) 647-4100

Other practice location 1

123 Stanley St
Morgantown, WV 26508-9115
Phone (432) 816-4130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241224000055 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466989819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
West Virginia University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Anesthesia Associates, PAGroup PAC ID 4981597838, 89 clinicians

Practice addresses (Care Compare)

9100 W 14TH St
Shawnee Mission, KS 66204-4004
Phone (913) 632-2230

Hospital & facility affiliations

  • Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111002WVMDRegistered Nurse
558242KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Associates, PA Registered Nurse CurrentSince Dec 1, 2024 Accepting new patients

Locations

7840 W 165th St
Overland Park, KS 66223
Phone (913) 236-6455

9301 W 74th St
Ste 300
Shawnee Msn, KS 66204
Phone (913) 632-9300

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1073390431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411895",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641411895",
            "telephone_number": "913-647-4100",
            "fax_number": "913-647-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-632-2230",
            "fax_number": "913-632-2297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Stanley St",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265089115",
            "country_code": "US",
            "telephone_number": "432-816-4130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANKHAUSER",
        "first_name": "SCOTT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "111002",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "558242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee Mission, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.