NPIMap

Organization Active NPI

Dreamland Uap Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Hazelwood, MO
National Provider Identifier
1073919494
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
DREAMLAND UAP ANESTHESIA, LLC
Practice address
100 Village SQ
Hazelwood, MO 63042-1820
Phone
(314) 373-8931
Fax
(314) 373-8935
NPI assigned
Nov 12, 2014
Last updated
Dec 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Authorized official

Name
Ms. Kimberly Michelle Harper
Title
Officer / Anesthesia Program Manage
Phone
(972) 713-3547

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X
Certified Registered Nurse AnesthetistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

100 Village SQ
Hazelwood, MO 63042-1820

Mailing address

15305 Dallas Pkwy
1600
Addison, TX 75001-4637
Phone (972) 713-3547

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150105001419 MO Part B Supplier - Clinic/Group Practice 9133442825 Receives reassigned benefits from 26 practitioners
Practice locations: Hazelwood, MO

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1073919494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15305 DALLAS PKWY",
            "address_2": "1600",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014637",
            "telephone_number": "972-713-3547",
            "fax_number": "972-534-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VILLAGE SQ",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421820",
            "telephone_number": "314-373-8931",
            "fax_number": "314-373-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAMLAND UAP ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICER / ANESTHESIA PROGRAM MANAGE",
        "authorized_official_telephone_number": "972-713-3547",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazelwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; 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.