Individual provider Active NPI

Robert Lyle Davis, CRNA

  • Certified Registered Nurse Anesthetist
  • Emporia, KS
National Provider Identifier
1194798405
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
55128 Issued in KS
Practice address
1201 West 12TH Avenue
Emporia, KS 66801-2531
Phone
(620) 343-6800
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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 55128 KS Primary

Addresses

Primary practice location

1201 West 12TH Avenue
Emporia, KS 66801-2531

Mailing address

1110 W 6TH Ave
Emporia, KS 66801-2531
Phone (620) 342-8748

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080505000388 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002995958 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emporia Anesthesia Associates PAGroup PAC ID 1456333509, 4 clinicians
Newman Memorial County HospitalGroup PAC ID 5193638526, shared by 6 NPIs, 61 clinicians

Practice addresses (Care Compare)

1201 W 12TH Ave
Emporia, KS 66801-2504
Phone (620) 343-6800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.14 of 100Reported as group
Quality
86.29
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
69222TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Newman Memorial County Hospital Current Accepting new patients
Newman Memorial County Hospital Current Accepting new patients
Emporia Anesthesia Associates PA Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2003 Accepting new patients
Newman Memorial County Hospital CurrentSince May 29, 2013 Accepting new patients
Newman Memorial County Hospital Past Accepting new patients

Locations

1301 W 12th Ave
Ste 301
Emporia, KS 66801
Phone (620) 343-2376

1201 W 12th Ave
Emporia, KS 66801
Phone (620) 343-2376

1110 W 6th Ave
Emporia, KS 66801
Phone (620) 342-8748

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 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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1194798405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W 6TH AVE",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668012531",
            "telephone_number": "620-342-8748",
            "fax_number": "620-342-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 WEST 12TH AVENUE",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668012531",
            "telephone_number": "620-343-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "middle_name": "LYLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "55128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emporia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.