Individual provider Active NPI

Kevin Whitney Hutcheson, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
National Provider Identifier
1225420904
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2015006785 Issued in MO
Practice address
3933 S Broadway
Saint Louis, MO 63118-4601
Phone
(314) 865-7039
NPI assigned
Mar 4, 2015
Last updated
Mar 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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 2015006785 MO Primary
Certified Registered Nurse Anesthetist 367500000X 041.373676 IL

Addresses

Primary practice location

3933 S Broadway
Saint Louis, MO 63118-4601

Mailing address

6044 Marmaduke Ave
Saint Louis, MO 63139-2612
Phone (309) 530-6798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150421000825 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315265436 Reassigns benefits to 3 organizations
I20150507000000 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315265436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialists in Anesthesia PCGroup PAC ID 2567369473, 7 clinicians

Practice addresses (Care Compare)

3933 S Broadway
Saint Louis, MO 63118-4601
Phone (314) 865-7992

5900 Bond Ave
Centreville, IL 62207-2326
Phone (618) 332-5480

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.373676ILMDCertified Registered Nurse Anesthetist
2015006785MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
SW Anesthesia LLC CurrentSince Jul 17, 2019 Accepting new patients

Locations

12345 W Bend Dr
Ste 200
Saint Louis, MO 63128
Phone (314) 843-8000

12345 W Bend Dr
Ste 201
Saint Louis, MO 63128
Phone (314) 722-2530

Organizations & group practices 2

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 3

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": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1225420904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6044 MARMADUKE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631392612",
            "telephone_number": "309-530-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3933 S BROADWAY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631184601",
            "telephone_number": "314-865-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHESON",
        "first_name": "KEVIN",
        "middle_name": "WHITNEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-04",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2015006785",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041.373676",
            "primary": false
        }
    ],
    "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 4, 2015; 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.