Individual provider Active NPI

Stephanie M Gotcher, CRNA

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1205336583
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
M111640 Issued in OK
Practice address
6839 S Canton Ave
Tulsa, OK 74136-3402
Phone
(918) 494-0612
NPI assigned
Feb 13, 2018
Last updated
Jan 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X M111640 OK Primary
Registered Nurse 163W00000X R088728 AR

Addresses

Primary practice location

6839 S Canton Ave
Tulsa, OK 74136-3402

Mailing address

6839 S Canton Ave
Tulsa, OK 74136-3402
Phone (918) 494-0612

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210310000432 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294081345 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
Ouachita Regional Anesthesia PLLCGroup PAC ID 4183619216, 18 clinicians

Practice addresses (Care Compare)

1910 Malvern Ave
Hot Springs, AR 71901-7752
Phone (501) 321-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R088728ARMDRegistered Nurse
M111640OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Arkansas Regional Medical Center CurrentSince Dec 1, 2024 Accepting new patients
North Arkansas Regional Medical Center Current Accepting new patients
Arkansas Anesthesia Associates, PLLC. CurrentSince Aug 10, 2021 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Dec 1, 2024 Accepting new patients
Ouachita Regional Anesthesia PLLC CurrentSince Oct 29, 2021 Accepting new patients

Locations

620 N Main St
#2
Harrison, AR 72601
Phone (870) 414-4000

620 N Main St
Fl Second
Harrison, AR 72601
Phone (870) 414-4000

620 N Willow St
Harrison, AR 72601
Phone (870) 365-2000

1910 Malvern Ave
Hot Springs National Park, AR 71901
Phone (501) 321-1000

10301 Kanis Rd
Little Rock, AR 72205
Phone (501) 604-4151

8820 Knoedl Ct
Little Rock, AR 72205
Phone (501) 224-6767

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1205336583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-494-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-494-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTCHER",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "M111640",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R088728",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.