Individual provider Active NPI

Charlotte M Cowan, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Kirksville, MO
National Provider Identifier
1194853515
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
121063 Issued in MO
Practice address
800 W Jefferson St
Northeast Regional Medical Center
Kirksville, MO 63501-1443
Phone
(660) 785-1000
Fax
(660) 785-1237
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2008

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 121063 MO Primary

Addresses

Primary practice location

800 W Jefferson St
Northeast Regional Medical Center
Kirksville, MO 63501-1443

Mailing address

PO Box 702
Kirksville, MO 63501-0702
Phone (660) 785-1000

Other identifiers 6

IdentifierTypeStateIssuer
0976845MedicaidIA
8298OtherMOHEALTHCARE USA (GROUP)
918400904MedicaidMO
CG4336OtherRAILROAD MEDICARE
P00130500OtherRAILROAD MEDICARE
80177OtherMOHEALTHCARE USA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040524000285 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022009455 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Orthopaedic Group LLPGroup PAC ID 9335042811, 91 clinicians

Practice addresses (Care Compare)

1 S Keene St
Columbia, MO 65201-7199
Phone (573) 443-2402

Merit-based Incentive Payment System (MIPS)

Final score
88.1 of 100Reported as group
Promoting interoperability
86
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Orthopaedic Group, LLP CurrentSince Jan 2, 2024 Accepting new patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Mar 30, 2023 Accepting new patients
Columbia Orthopaedic Group, LLP CurrentSince Jan 2, 2024 Accepting new patients
Capital Anesthesia Solutions of Missouri, LLC CurrentSince May 1, 2021 Accepting new patients

Locations

1410 Forum Katy Pkwy
Ste 102
Columbia, MO 65203
Phone (573) 397-6556

1 S Keene St
Columbia, MO 65201
Phone (573) 443-2402

1 S Keene St
Ste 100
Columbia, MO 65201
Phone (573) 499-6501

315 S Osteopathy Ave
Kirksville, MO 63501
Phone (660) 785-1000

1515 Union Ave
Moberly, MO 65270
Phone (660) 263-2400

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1194853515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 702",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635010702",
            "telephone_number": "660-785-1000",
            "fax_number": "660-785-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W JEFFERSON ST",
            "address_2": "NORTHEAST REGIONAL MEDICAL CENTER",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635011443",
            "telephone_number": "660-785-1000",
            "fax_number": "660-785-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWAN",
        "first_name": "CHARLOTTE",
        "middle_name": "M",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2008-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "121063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0976845",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA (GROUP)",
            "identifier": "8298",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "918400904",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG4336",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00130500",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "80177",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; 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.