Individual provider Active NPI

Mitchell L Simmons, CRNA

  • Certified Registered Nurse Anesthetist
  • Kansas City, MO
National Provider Identifier
1215044623
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
153380 Issued in MO
Practice address
2301 Holmes St
Kansas City, MO 64108-2640
Phone
(816) 404-1100
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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 153380 MO Primary

Addresses

Primary practice location

2301 Holmes St
Kansas City, MO 64108-2640

Mailing address

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-1100

Other practice location 1

7900 Holmes Rd
Kansas City, MO 64131-2112
Phone (816) 404-9382

Other identifiers 2

IdentifierTypeStateIssuer
916875305MedicaidMO
36754011OtherMOBCBS OF KANSAS CITY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060321000593 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456368117 Reassigns benefits to 1 organization
I20150218001196 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456368117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Truman Medical Center IncorporatedGroup PAC ID 7315841418, 237 clinicians

Practice addresses (Care Compare)

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-7000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Truman Medical Center, Incorporated Current Accepting new patients
Truman Medical Center Incorporated Current Accepting new patients
Truman Medical Center, Incorporated CurrentSince Dec 24, 2014 Accepting new patients
Truman Medical Center Incorporated Current Accepting new patients
Truman Medical Center Incorporated CurrentSince Dec 24, 2014 Accepting new patients
Truman Medical Center Incorporated Current Accepting new patients
Midwest Anesthesia Associates, PA Nurse Anesthetist, Certified Registered CurrentSince Jan 30, 2015 Accepting new patients
Truman Medical Center Incorporated Current Accepting new patients
Truman Medical Center, Incorporated Current Accepting new patients
St Joseph Anesthesia Services, P.C. Past Accepting new patients
Truman Medical Centers, Inc. Past Accepting new patients
St Lukes East Anesthesia Services,P.C. Past Accepting new patients

Locations

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

7900 Lees Summit Rd
Ste 374
Kansas City, MO 64139

2301 Holmes St
Kansas City, MO 64108

Organizations & group practices 12

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1215044623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 HOLMES ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082640",
            "telephone_number": "816-404-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HOLMES ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082640",
            "telephone_number": "816-404-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7900 Holmes Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641312112",
            "country_code": "US",
            "telephone_number": "816-404-9382",
            "fax_number": "816-404-7142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MITCHELL",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "153380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "916875305",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KANSAS CITY",
            "identifier": "36754011",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.