Individual provider Active NPI

Jeff Andrew Carpenter, CRNA

  • Certified Registered Nurse Anesthetist
  • Andover, KS
National Provider Identifier
1164907408
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
TMP-157280 Issued in KS
Practice address
1124 W 21St St
Andover, KS 67002-5500
Phone
(316) 300-4000
NPI assigned
Oct 2, 2018
Last updated
Oct 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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 TMP-157280 KS Primary

Addresses

Primary practice location

1124 W 21St St
Andover, KS 67002-5500

Mailing address

1124 W 21St St
Andover, KS 67002-5500
Phone (806) 220-9802

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181024000298 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739432691 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas Anesthesia Providers, LLCGroup PAC ID 6305206764, 24 clinicians
Kansas Spine Anesthesia Corporation PAGroup PAC ID 1153586821, 56 clinicians

Practice addresses (Care Compare)

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

3333 N Webb Rd
Wichita, KS 67226-8123
Phone (316) 462-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.33 of 100Reported as group
Quality
59.78
Promoting interoperability
97
Improvement activities
40
Cost
73.83

Merit-based Incentive Payment System (MIPS)

Final score
40.05 of 100Reported as group
Quality
47.12
Improvement activities
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TMP-157280KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Medical Center LLC Current Accepting new patients
Kansas Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 7, 2023 Accepting new patients
Kansas Spine Anesthesia Corporation PA Nurse Anesthetist, Certified Registered CurrentSince Jul 17, 2022 Accepting new patients
Kansas Medical Center, LLC Current Accepting new patients
Kansas Medical Center, LLC CurrentSince Oct 1, 2018 Accepting new patients
Kansas Medical Center, LLC CurrentSince Oct 1, 2018 Accepting new patients

Locations

1124 W 21st St
Andover, KS 67002
Phone (316) 300-4000

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

2818 N Greenwich Rd
Wichita, KS 67226
Phone (316) 685-2207

3121 N Webb Rd
Ste 100
Wichita, KS 67226

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

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

4013 N Ridge Rd
Ste 100
Wichita, KS 67205
Phone (316) 722-8015

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

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

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

Organizations & group practices 6

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 2

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": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1164907408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 W 21ST ST",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670025500",
            "telephone_number": "806-220-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 W 21ST ST",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670025500",
            "telephone_number": "316-300-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "JEFF",
        "middle_name": "ANDREW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "TMP-157280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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.