Individual provider Active NPI

Tara Lynn Weirich, CRNA

  • Certified Registered Nurse Anesthetist
  • Des Peres, MO
National Provider Identifier
1104004134
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209006957 Issued in IL
Practice address
12990 Manchester Rd
Des Peres, MO 63131-1860
Phone
(314) 367-1181
NPI assigned
Jan 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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 209006957 IL Primary

Addresses

Primary practice location

12990 Manchester Rd
Des Peres, MO 63131-1860

Mailing address

16552 State Highway 109
Dow, IL 62022-3067
Phone (618) 567-3706

Other practice location 1

9515 Holy Cross Ln
Breese, IL 62230-3618
Phone (618) 526-5829

Other practice location 2

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

Other practice location 3

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (618) 498-6402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080213000124 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012090103 Reassigns benefits to 4 organizations
I20151110003054 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012090103 Reassigns benefits to 2 organizations

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
Eye Anesthesia LLCGroup PAC ID 5698922581, 10 clinicians
Jersey Community HospitalGroup PAC ID 4587650445, 62 clinicians

Practice addresses (Care Compare)

12990 Manchester Rd
Suite 105
Saint Louis, MO 63131-1860
Phone 31468642004220

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (618) 498-6402

Hospital & facility affiliations

  • Jersey Community Hospital Hospital, Jerseyville, IL, CCN 140059

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jersey Community Hospital CurrentSince Oct 1, 2020 Accepting new patients
Jersey Community Hospital Current Accepting new patients
Eye Anesthesia LLC CurrentSince Dec 1, 2015 Accepting new patients
Jersey Community Hospital District CurrentSince Oct 1, 2020 Accepting new patients
Midwest Anesthesia Associates, P.C. CurrentSince Jun 1, 2023 Accepting new patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2016 Accepting new patients
Millennium Anesthesiology Consultants, LLC CurrentSince Oct 1, 2018 Accepting new patients
Jersey Community Hospital Past Accepting new patients
Figueroa and Associates Anesthesia Group, LTD. Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

2 Memorial Dr
Alton, IL 62002
Phone (618) 462-0710

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

400 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-6402

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

12990 Manchester Rd
Ste 105
Saint Louis, MO 63131
Phone (314) 686-4200

12990 Manchester Rd
Saint Louis, MO 63131
Phone (314) 432-6137

12990 Manchester Rd
Ste 103
Saint Louis, MO 63131
Phone (314) 686-4200

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f4be81d1-a15e-4e19-9601-5214010ddaac/
  • FHIR API: https://fhir-usa.unify.chbase.com/org/jersey-f23a6357

Organizations & group practices 9

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": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1104004134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16552 STATE HIGHWAY 109",
            "city": "DOW",
            "state": "IL",
            "postal_code": "620223067",
            "telephone_number": "618-567-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12990 MANCHESTER RD",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311860",
            "telephone_number": "314-367-1181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9515 Holy Cross Ln",
            "address_purpose": "LOCATION",
            "city": "Breese",
            "state": "IL",
            "postal_code": "622303618",
            "country_code": "US",
            "telephone_number": "618-526-5829",
            "fax_number": "618-526-8050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Saint Elizabeth Blvd",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622691099",
            "country_code": "US",
            "telephone_number": "618-234-2120",
            "fax_number": "618-641-5810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Maple Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Jerseyville",
            "state": "IL",
            "postal_code": "620522028",
            "country_code": "US",
            "telephone_number": "618-498-6402",
            "fax_number": "618-498-8439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIRICH",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209006957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Peres, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.