Individual provider Active NPI

Raymond N Eisenmann, CRNA

  • Certified Registered Nurse Anesthetist
  • Joplin, MO
National Provider Identifier
1164430880
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
143488 Issued in MO
Practice address
100 Mercy Way
Joplin, MO 64804-4524
Phone
(417) 556-3570
Fax
(417) 556-6475
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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 143488 MO Primary

Addresses

Primary practice location

100 Mercy Way
Joplin, MO 64804-4524

Mailing address

PO Box 7411626
Chicago, IL 60674-5626

Other practice location 1

525 Branson Landing Blvd
Branson, MO 65616-2052
Phone (000) 000-0000

Other identifiers 4

IdentifierTypeStateIssuer
P01387877OtherMORAIL ROAD MEDICARE
200533700AMedicaidOK
1164430880MedicaidMO
201098710BMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120109000053 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385810621 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

525 Branson Landing Blvd
Branson, MO 65616-2052

525 Branson Landing Blvd
Suite 508
Branson, MO 65616-2131
Phone (417) 335-7540

Hospital & facility affiliations

  • Cox Medical Center Branson Hospital, Branson, MO, CCN 260094

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Jul 7, 2025 Accepting new patients
Northstar Anesthesia of Missouri, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2016 Accepting new patients
St Joseph Anesthesia Services, P.C. Past Accepting new patients

Locations

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1000 Carondelet Dr
Kansas City, MO 64114
Phone (816) 942-4400

Organizations & group practices 5

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 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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1164430880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7411626",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606745626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-556-3570",
            "fax_number": "417-556-6475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Branson Landing Blvd",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656162052",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EISENMANN",
        "first_name": "RAYMOND",
        "middle_name": "N",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "143488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01387877",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200533700A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164430880",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201098710B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; 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.