NPIMap

Organization Active NPI

Kennett Hma Physician Management, Inc.

  • Certified Registered Nurse Anesthetist
  • Kennett, MO
National Provider Identifier
1114172111
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
KENNETT HMA PHYSICIAN MANAGEMENT, INC.
Doing business as
Kennett Anesthesia Associates
Practice address
1301 1St St
Kennett, MO 63857-2525
Phone
(573) 888-8424
Fax
(573) 888-2715
NPI assigned
Nov 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Authorized official

Name
Ms. Michelle M Beacham
Title
Controller
Phone
(573) 888-8424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1301 1St St
Kennett, MO 63857-2525

Mailing address

1231 1St St
Suite 8
Kennett, MO 63857-2527
Phone (573) 888-8424

Other identifiers 1

IdentifierTypeStateIssuer
500451901MedicaidMO

Other names 1

  • Kennett Anesthesia Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kennett Hma Phys MGMT LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227052800000",
    "number": "1114172111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 1ST ST",
            "address_2": "SUITE 8",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572527",
            "telephone_number": "573-888-8424",
            "fax_number": "573-888-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 1ST ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572525",
            "telephone_number": "573-888-8424",
            "fax_number": "573-888-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETT HMA PHYSICIAN MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-19",
        "last_updated": "2008-11-19",
        "status": "A",
        "authorized_official_last_name": "BEACHAM",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "573-888-8424",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500451901",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennett Anesthesia Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennett, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.