Individual provider Active NPI

Kelly J McCollegan, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbia, MO
National Provider Identifier
1235377839
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2011028679 Issued in MO
Practice address
1 Hospital Dr
Columbia, MO 65201-5276
Phone
(573) 882-2568
Fax
(573) 882-2226
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 041336818 IL
Certified Registered Nurse Anesthetist 367500000X APRN11015291 FL
Certified Registered Nurse Anesthetist 367500000X 2011028679 MO Primary

Addresses

Primary practice location

1 Hospital Dr
Columbia, MO 65201-5276

Mailing address

PO Box 7687
Columbia, MO 65205-7687
Phone (573) 882-2568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO, FL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090305000405 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183780745
I20120117000679 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183780745 Reassigns benefits to 2 organizations
I20241107004175 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183780745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

11190 Health Park Blvd
Naples, FL 34110-5729
Phone (239) 624-5000

Hospital & facility affiliations

  • Naples Community Hospital Hospital, Naples, FL, CCN 100018

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041336818ILMDCertified Registered Nurse Anesthetist
2011028679MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Nov 5, 2024 Accepting new patients
Mid-America Anesthesia Consultants, PC CurrentSince Jan 11, 2014 Accepting new patients
Gastrointestinal Associates, LLC CurrentSince Jan 12, 2019 Accepting new patients

Locations

3650 NW 82nd Ave
Ste 101
Doral, FL 33166
Phone (305) 341-7280

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

305 N Keene St
Ste 107
Columbia, MO 65201
Phone (573) 239-3310

210 Portland St
Ste 100
Columbia, MO 65201
Phone (573) 777-8818

Interoperability endpoints

  • FHIR API: https://ff23a4b4-465d-44fa-a7d8-99a59a9660e5.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 3

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 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": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1235377839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7687",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652057687",
            "telephone_number": "573-882-2568",
            "fax_number": "573-882-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015276",
            "telephone_number": "573-882-2568",
            "fax_number": "573-882-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLEGAN",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041336818",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11015291",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2011028679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.