Individual provider Active NPI

Anne Elizabeth Teachout, CRNA

  • Certified Registered Nurse Anesthetist
  • Aberdeen, SD
National Provider Identifier
1073636213
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2007006425 Issued in MO
Practice address
305 S State St
Aberdeen, SD 57401-4527
Phone
(605) 622-5000
Fax
(605) 622-5542
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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 2007006425 MO Primary

Addresses

Primary practice location

305 S State St
Aberdeen, SD 57401-4527

Mailing address

PO Box 1460
Aberdeen, SD 57402-1460
Phone (605) 622-2876

Other identifiers 2

IdentifierTypeStateIssuer
910099902MedicaidMO
200426780AMedicaidKS

Other names 1

  • Anne Elizabeth Smith Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110627000658 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911002662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St LukesGroup PAC ID 6406764927, 164 clinicians

Practice addresses (Care Compare)

305 S State St
Aberdeen, SD 57401-4527
Phone (605) 622-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007006425MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St. Lukes CurrentSince May 19, 2011 Accepting new patients
Avera St. Luke'S CurrentSince May 19, 2011 Accepting new patients
Anesthesia Associates of Kansas City PA Past Accepting new patients

Locations

305 S State St
Aberdeen, SD 57401
Phone (605) 229-3000

Organizations & group practices 3

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 1

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1073636213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574021460",
            "telephone_number": "605-622-2876",
            "fax_number": "605-622-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S STATE ST",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014527",
            "telephone_number": "605-622-5000",
            "fax_number": "605-622-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEACHOUT",
        "first_name": "ANNE",
        "middle_name": "ELIZABETH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2007006425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910099902",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200426780A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "SMITH",
            "middle_name": "ELIZABETH",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aberdeen, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.