Individual provider Active NPI

Kevin J Lockett, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbia, MO
National Provider Identifier
1265483028
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN096709 Issued in MO
Practice address
210 Portland St Ste 100
Columbia, MO 65201-6677
Phone
(573) 777-8818
Fax
(573) 777-8819
NPI assigned
May 15, 2006
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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 RN096709 MO Primary

Addresses

Primary practice location

210 Portland St Ste 100
Columbia, MO 65201-6677

Mailing address

210 Portland St Ste 100
Columbia, MO 65201-6677
Phone (573) 777-8818

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041013000096 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103886338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Associates, LLCGroup PAC ID 9537166236, 30 clinicians

Practice addresses (Care Compare)

210 Portland St
Suite 100
Columbia, MO 65201-6677
Phone (573) 777-8818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN096709MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Associates, LLC CurrentSince Feb 1, 2024 Accepting new patients
Lake of the Ozarks Pain Management Services, Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Collier Anesthesia PA Past Accepting new patients
St Joseph Anesthesia Services, P.C. Past Accepting new patients

Locations

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 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1265483028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 PORTLAND ST STE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016677",
            "telephone_number": "573-777-8818",
            "fax_number": "573-777-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 PORTLAND ST STE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016677",
            "telephone_number": "573-777-8818",
            "fax_number": "573-777-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKETT",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "RN096709",
            "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 Feb 23, 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.