Individual provider Active NPI

Melanie J Guthrie, AA

  • Anesthesiologist Assistant
  • Liberty, MO
National Provider Identifier
1124191143
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
2006028762 Issued in MO
Practice address
2525 Glenn Hendren Dr
Liberty, MO 64068-9625
Phone
(816) 781-7200
Fax
(816) 792-7196
NPI assigned
Nov 16, 2006
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 2006028762 MO Primary

Addresses

Primary practice location

2525 Glenn Hendren Dr
Liberty, MO 64068-9625

Mailing address

PO Box 804408
Kansas City, MO 64180-4408
Phone (913) 647-4100

Other practice location 1

4510 Frederick Ave
Saint Joseph, MO 64506-3238
Phone (816) 364-9992

Other identifiers 3

IdentifierTypeStateIssuer
917444408MedicaidMO
P00361612OtherMORR MEDICARE
38005019OtherMOBCBS KC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061213000621 MO Practitioner - Anesthesiology Assistant 9335148683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthetic Care IncGroup PAC ID 2365425865, 30 clinicians

Practice addresses (Care Compare)

2525 Glenn Hendren Dr
Liberty, MO 64068-9625
Phone (816) 781-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
003020GAMDOccupational Therapist
2006028762MOMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Anesthetic Care Inc CurrentSince Sep 14, 2006 Accepting new patients
James F Piontek Inc PastSince Dec 13, 2020 Accepting new patients

Locations

2525 Glenn Hendren Dr
Liberty, MO 64068
Phone (816) 781-7200

2529 Glenn Hendren Dr
Ste 100
Liberty, MO 64068
Phone (816) 781-7200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1124191143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 804408",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641804408",
            "telephone_number": "913-647-4100",
            "fax_number": "913-647-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 GLENN HENDREN DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640689625",
            "telephone_number": "816-781-7200",
            "fax_number": "816-792-7196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4510 Frederick Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645063238",
            "country_code": "US",
            "telephone_number": "816-364-9992",
            "fax_number": "816-336-9996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTHRIE",
        "first_name": "MELANIE",
        "middle_name": "J",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2006028762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "917444408",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00361612",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "38005019",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.