Tara M Kinney, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209009089 Issued in IL

Practice address

3400 Dexter CT Ste 104
Davenport, IA 52807-3419

Phone

(563) 334-0234

Fax

(563) 334-0235

NPI assigned

Apr 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Precision Anesthesia LLCGroup PAC ID 9335378264, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Precision Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Davenport, IA
  • NPI 1053741322

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Quad Cities Integrative Wellness

  • Clinical Social Worker
  • Davenport, IA
  • NPI 1659222313
  NPD Authorized official
• Quad Cities Ketamine Clinic

  dba Quad Cities Ketamine & Wellness Clinic

  • Nurse Practitioner
  • Davenport, IA
  • NPI 1629781935
  NPD Authorized official
• Apollo Anesthesia and Pain Management, PLLC

  • Certified Registered Nurse Anesthetist
  • Moline, IL
  • NPI 1265051817

  IA

  Medicare reassignment

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1164748646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DEXTER CT STE 104",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073419",
            "telephone_number": "563-334-0234",
            "fax_number": "563-334-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DEXTER CT STE 104",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073419",
            "telephone_number": "563-334-0234",
            "fax_number": "563-334-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "TARA",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-09",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1566983",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209009089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00849727",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Kime, D.C.
• King Chiropractic LLC (Wholistic Family Chiropractic)
• Jennifer King, TLMHC
• Rachel Flint King, AU.D.
• Christopher J Kingma, D.D.S., M.S.
• Lynette Kirk, LISW
• Chelsie Kirschbaum
• Jacqueline Elizabeth Kitchen, M.D.
• Eric Kitzmann, O.D.
• Susan Langewisch Kivisto

• Certified Registered Nurse Anesthetist in Davenport, IA
• Providers in Davenport, IA by specialty
• Certified Registered Nurse Anesthetist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.