Caitlin E Clark, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Shawnee Mission, KS
NPI 1093285017 · NPPES record last updated Jan 25, 2019
Key facts
- NPI
- 1093285017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 557656 (KS)
- Practice address
- 9100 W 74TH St
Shawnee Mission, KS 66204-4004 - Phone
- (913) 632-2230
- Fax
- (913) 632-2297
- NPI assigned
- Dec 3, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northstar Anesthesia of Kansas LLC
Midwest Anesthesia Associates, PA
Practice addresses (Care Compare)
8929 Parallel Pkwy
Kansas City, KS 66112-1689
Phone (913) 596-4000
9100 W 14TH St
Shawnee Mission, KS 66204-4004
Phone (913) 632-2230
Hospital & facility affiliations
- Adventhealth Shawnee Mission
- Providence Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190328001619 | KS | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9739429747 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119760 | KS | MD | Registered Nurse |
| 557656 | KS | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Anesthesia Associates, PA | Registered Nurse | Current |
Accepting new patients |
| Northstar Anesthesia of Kansas, LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
Locations
8929 Parallel Pkwy
Kansas City, KS 66112
Phone (913) 596-3930
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 119760 | KS | |
| Certified Registered Nurse Anesthetist | 367500000X | 557656 | KS | Yes |
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 names
- Caitlin E Gardner
Other providers in Shawnee Mission, KS
- Obidi Obinwa Chigbo
- Timothy Joseph Chilcote
- Children'S Mercy-Johnson County Pediatrics, Inc
- Brett L Cikanek
- Lindsey Ragland Clancey
- Mark J Clifft
- Kimberly Ann Cochran
- Emmett Love Coleman
- Colon and Rectal Surgeons of KC PA
- Colorectal Surgery PA
All providers in Shawnee Mission, KS · Certified Registered Nurse Anesthetist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.