Individual provider Active NPI

Fara E Simons, CRNA

  • Certified Registered Nurse Anesthetist
  • Wichita, KS
National Provider Identifier
1164414348
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
55410 Issued in KS
Practice address
550 N Hillside St
Wichita, KS 67214-4910
Phone
(316) 962-3030
NPI assigned
Aug 16, 2005
Last updated
Apr 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 55410 KS Primary

Addresses

Primary practice location

550 N Hillside St
Wichita, KS 67214-4910

Mailing address

8080 E Central Ave
Suite 250
Wichita, KS 67206-2361
Phone (316) 686-7327

Other identifiers 1

IdentifierTypeStateIssuer
200302760AMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050122000015 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395794887 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas Anesthesia Providers, LLCGroup PAC ID 6305206764, 24 clinicians
Ophthalmic Anesthesia Team PAGroup PAC ID 3678576808, 2 clinicians

Practice addresses (Care Compare)

1124 W 21St St
100 Andover Ambulatory Surgery Center
Andover, KS 67002-5500
Phone (316) 440-3200

6100 E Central Ave
5 Team Vision Surgery Center
Wichita, KS 67208-4237
Phone (620) 584-2002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55410KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Anesthesia Team PA Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2018 Accepting new patients
Kansas Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 15, 2023 Accepting new patients
Kansas Spine Anesthesia Corporation PA Nurse Anesthetist, Certified Registered CurrentSince Nov 19, 2014 Accepting new patients

Locations

1124 W 21st St
#100
Andover, KS 67002
Phone (316) 440-3200

1708 E 23rd Ave
Hutchinson, KS 67502
Phone (620) 663-7187

1821 N Webb Rd
Wichita, KS 67206
Phone (316) 688-3960

3223 N Webb Rd
Ste 5
Wichita, KS 67226
Phone (316) 462-5000

3333 N Webb Rd
Wichita, KS 67226
Phone (316) 462-5000

6100 E Central Ave
Ste 5
Wichita, KS 67208
Phone (316) 681-2020

7550 W Village Cir
Ste B
Wichita, KS 67205
Phone (316) 838-8388

8080 E Central Ave
Ste 250
Wichita, KS 67206
Phone (316) 686-1564

9050 E 29th St N
Ste 100
Wichita, KS 67226
Phone (316) 219-9651

9300 E 29th St N
Ste 100
Wichita, KS 67226
Phone (316) 634-0404

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1164414348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 E CENTRAL AVE",
            "address_2": "SUITE 250",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062361",
            "telephone_number": "316-686-7327",
            "fax_number": "316-686-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144910",
            "telephone_number": "316-962-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "FARA",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "55410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200302760A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.