Active NPI
Matthew T Gaddis, CRNA
- Certified Registered Nurse Anesthetist
- Springfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2011022951
- Practice address
- 1235 E Cherokee St
Springfield, MO 65804-2203 - Phone
- (417) 820-2829
- Fax
- (417) 820-8852
- NPI assigned
- Jul 26, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2011022951 | MO | Primary |
Addresses
Primary practice location
1235 E Cherokee St
Springfield, MO 65804-2203
Mailing address
PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110901000540 | MO | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 7810167715 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Clinic Springfield Communities
Practice addresses (Care Compare)
1235 E Cherokee St
Springfield, MO 65804-2203
2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905
Hospital & facility affiliations
- Mercy Hospital Springfield
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients |
Locations
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379
620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215
1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
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.
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
MO
-
- Family Medicine Physician
- Hollister, MO
- NPI 1053350454
Hospital & facility affiliations 9
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": "1311638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311638400000",
"number": "1265710107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2580",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658012580",
"telephone_number": "417-829-4620",
"fax_number": "417-829-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 E CHEROKEE ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042203",
"telephone_number": "417-820-2829",
"fax_number": "417-820-8852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GADDIS",
"first_name": "MATTHEW",
"middle_name": "T",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-26",
"last_updated": "2011-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2011022951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.