Individual provider Active NPI

Kimberly A. Moleski Powderly, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
National Provider Identifier
1194067652
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2008023276 Issued in MO
Practice address
6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone
(314) 768-8442
Fax
(314) 768-8918
NPI assigned
Mar 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 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 2008023276 MO Primary

Addresses

Primary practice location

6420 Clayton Rd
Saint Louis, MO 63117-1811

Mailing address

6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8442

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130821000887 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850534926 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomed Staffing LLCGroup PAC ID 9638429178, 373 clinicians

Practice addresses (Care Compare)

5139 Mattis Rd
Suite 100
Saint Louis, MO 63128-2250
Phone (469) 863-9978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008023276MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
G & G Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
Metro-West Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2022 Accepting new patients
Orthomed Staffing LLC CurrentSince Aug 15, 2023 Accepting new patients

Locations

17050 Baxter Rd
Ste 110
Chesterfield, MO 63005
Phone (636) 537-0122

305 N Keene St
Ste 107
Columbia, MO 65201
Phone (573) 239-3310

211 NE 54th St
Ste 100
Kansas City, MO 64118
Phone (816) 455-4214

200 NE 54th St
Unit 200
Kansas City, MO 64118

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

1040 Old des Peres Rd
Saint Louis, MO 63131
Phone (314) 729-9780

9701 Landmark Parkway Dr
Ste 100
Saint Louis, MO 63127
Phone (314) 396-9517

10435 Clayton Rd
Ste 110
Saint Louis, MO 63131
Phone (314) 576-1400

4594 S Lindbergh Blvd
Saint Louis, MO 63127
Phone (314) 842-2607

12639 Old Tesson Rd
Ste 130
Saint Louis, MO 63128
Phone (314) 729-0785

5139 Mattis Rd
Ste 100
Saint Louis, MO 63128
Phone (314) 396-9517

1050 Old des Peres Rd
Ste 150
Saint Louis, MO 63131
Phone (314) 396-9517

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

5401 Veterans Memorial Pkwy
Ste 100
Saint Peters, MO 63376
Phone (636) 441-0906

4801 Weldon Spring Pkwy
Weldon Spring, MO 63304
Phone (636) 441-7300

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": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1194067652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8442",
            "fax_number": "314-768-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8442",
            "fax_number": "314-768-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLESKI POWDERLY",
        "first_name": "KIMBERLY",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2008023276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.