Individual provider Active NPI

Kimberly A. Moore, CRNA

  • Certified Registered Nurse Anesthetist
  • North Kansas City, MO
National Provider Identifier
1104910934
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2010042084 Issued in MO
Practice address
2800 Clay Edwards Dr
North Kansas City, MO 64116-3220
Phone
(816) 221-5050
Fax
(816) 471-1247
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2010042084 MO Primary
Registered Nurse 163W00000X 2012031468 MO

Addresses

Primary practice location

2800 Clay Edwards Dr
North Kansas City, MO 64116-3220

Mailing address

1900 Swift Ave Ste 203
PO Box 7391
North Kansas City, MO 64116-3400
Phone (816) 221-5050

Other names 1

  • Kimberly A Whitney Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120514000031 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901906429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Orthopaedic Group LLPGroup PAC ID 9335042811, 91 clinicians

Practice addresses (Care Compare)

1 S Keene St
Columbia, MO 65201-7199
Phone (573) 443-2402

Merit-based Incentive Payment System (MIPS)

Final score
88.1 of 100Reported as group
Promoting interoperability
86
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012031468MOMDRegistered Nurse
2010042084MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Orthopaedic Group, LLP CurrentSince Jan 2, 2024 Accepting new patients
Columbia Orthopaedic Group, LLP CurrentSince Jan 2, 2024 Accepting new patients
Purchase Anesthesia, PSC Nurse Anesthetist, Certified Registered PastSince Apr 1, 2005 Accepting new patients

Locations

1 S Keene St
Ste 1
Columbia, MO 65201

1 S Keene St
Ste 100
Columbia, MO 65201
Phone (573) 499-6501

1 S Keene St
Columbia, MO 65201
Phone (573) 443-2402

1410 Forum Katy Pkwy
Ste 102
Columbia, MO 65203
Phone (573) 397-6556

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1104910934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SWIFT AVE STE 203",
            "address_2": "PO BOX 7391",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163400",
            "telephone_number": "816-221-5050",
            "fax_number": "816-471-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLAY EDWARDS DR",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163220",
            "telephone_number": "816-221-5050",
            "fax_number": "816-471-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KIMBERLY",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2010042084",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2012031468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WHITNEY",
            "middle_name": "A",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.