Organization Active NPI

Draper Anesthesia Services, PC

  • Certified Registered Nurse Anesthetist
  • Oklahoma City, OK
National Provider Identifier
1245264241
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
67878 Issued in OK
Legal business name
DRAPER ANESTHESIA SERVICES, PC
Practice address
14000 N Portland Ave Ste 102
Oklahoma City, OK 73134
Phone
(405) 418-4800
Fax
(405) 418-4820
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Authorized official

Name
Cheri Moore
Title
Credentialing Specialist
Phone
(405) 608-5329

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 67878 OK Primary

Addresses

Primary practice location

14000 N Portland Ave Ste 102
Oklahoma City, OK 73134

Mailing address

PO Box 272605
Oklahoma City, OK 73137-2605
Phone (405) 418-4800

Other identifiers 3

IdentifierTypeStateIssuer
DG1017OtherOKMEDICARE RR
20418590001OtherOKBC/BS
200075290AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060509000395 OK Part B Supplier - Clinic/Group Practice 0547271306 Receives reassigned benefits from 2 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

8100 S Walker Ave
Oklahoma City, OK 73139
Phone (405) 602-6500

14000 N Portland Ave
Ste 102
Oklahoma City, OK 73134
Phone (405) 608-5329

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1245264241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 272605",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731372605",
            "telephone_number": "405-418-4800",
            "fax_number": "405-418-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 N PORTLAND AVE STE 102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73134",
            "telephone_number": "405-418-4800",
            "fax_number": "405-418-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAPER ANESTHESIA SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHERI",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "405-608-5329"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "67878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DG1017",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "20418590001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200075290A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.