David Carl Bose, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Lakin, KS
NPI 1114973906 · NPPES record last updated Mar 21, 2016
Key facts
- NPI
- 1114973906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 55452 (KS)
- Practice address
- 500 E Thorpe St
Lakin, KS 67860-9625 - Phone
- (620) 355-7111
- Fax
- (620) 355-1527
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190918001402 | TX | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8123033727 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Independent Physicians Network PLLC | Current |
Accepting new patients | |
| Anesthesia Critical Care Nursing,PA | Past | Accepting new patients | |
| Northwest Kansas Pain & Anesthesia, PA | Past | Accepting new patients |
Locations
3300 Oak Lawn Ave
Ste 200
Dallas, TX 75219
Phone (214) 252-3500
5601 Warren Pkwy
Frisco, TX 75034
Phone (214) 407-5000
6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000
231 S Collins Rd
Sunnyvale, TX 75182
Phone (972) 203-6240
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 55452 | KS | Yes |
Addresses
Primary practice location
500 E Thorpe St
Lakin, KS 67860-9625
Mailing address
PO Box 821
P.O. Box 1023
Hays, KS 67601-0821
Phone (785) 628-8300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200369140A | Medicaid | KS |
Other providers in Lakin, KS
- Advocacy Services of Western Kansas, Inc
- Advocacy Services of Western Kansas, LLC
- Morayma Cruz Aviles
- Tiana Marie Stebens Bishop
- Katrina L Brown
- Lauren A Brown
- Brunswig Pharmacy PA
- Bryant Chiropractic Clinic PA
- Tiffany Ann Bryant
All providers in Lakin, 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 Mar 21, 2016. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.