Individual provider Active NPI

Susan D Jenkins, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Coffeyville, KS
National Provider Identifier
1154434686
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4355524 Issued in KS
Practice address
1400 W 4TH St
Coffeyville, KS 67337-3306
Phone
(620) 251-1200
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1354266031 KS
Registered Nurse 163W00000X 108151 MO
Certified Registered Nurse Anesthetist 367500000X 2010035242 MO
Certified Registered Nurse Anesthetist 367500000X 4355524 KS Primary

Addresses

Primary practice location

1400 W 4TH St
Coffeyville, KS 67337-3306

Mailing address

1400 W 4TH St
Coffeyville, KS 67337-3306
Phone (620) 251-1200

Other practice location 1

1 Hospital Dr
Columbia, MO 65201-5276
Phone (573) 882-2568

Other identifiers 2

IdentifierTypeStateIssuer
P00380549OtherKSRR MEDICARE
200400270AMedicaidKS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110120001216 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224034483 Reassigns benefits to 3 organizations

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
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians
St Lukes East Anesthesia Services PCGroup PAC ID 1850333477, 44 clinicians

Practice addresses (Care Compare)

100 NE Saint Lukes Blvd
BLDG 20
Lees Summit, MO 64086-6000
Phone (816) 932-2836

120 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone (816) 347-5800

Hospital & facility affiliations

  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
  • Saint Luke'S East Hospital Hospital, Lees Summit, MO, CCN 260216

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1354266031KSMDRegistered Nurse
108151MOMDRegistered Nurse
4355524KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 28, 2025 Accepting new patients
Curators of the University of Missouri CurrentSince Dec 22, 2010 Accepting new patients
The Curators of the University of Missouri CurrentSince Dec 22, 2010 Accepting new patients
St Lukes East Anesthesia Services,P.C. CurrentSince Oct 1, 2022 Accepting new patients
Westglen Endoscopy Center LLC Past Accepting new patients
Midwest Anesthesia Associates, PA Registered Nurse Past Accepting new patients
Saint Lukes Physician Group II LLC PastSince Dec 28, 2025 Accepting new patients

Locations

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

404 N Keene St
Columbia, MO 65201
Phone (573) 875-9000

1 Hospital Dr
Columbia, MO 65201
Phone (573) 882-2568

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

100 NE Saint Lukes Blvd
Bldg 20
Lees Summit, MO 64086

100 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5097

120 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5800

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Organizations & group practices 7

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 3

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1154434686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W 4TH ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373306",
            "telephone_number": "620-251-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W 4TH ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373306",
            "telephone_number": "620-251-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652015276",
            "country_code": "US",
            "telephone_number": "573-882-2568",
            "fax_number": "573-882-2226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2022-09-02",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "1354266031",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "108151",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2010035242",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "4355524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00380549",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200400270A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DIRECT",
            "address_1": "1 Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coffeyville, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.