Individual provider Active NPI

Komla Wella Badjalimbe, C.R.N.A

  • Certified Registered Nurse Anesthetist
  • Kansas City, KS
National Provider Identifier
1275982126
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
43-557411-081 Issued in KS
Practice address
3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone
(913) 588-3316
NPI assigned
Jun 10, 2016
Last updated
Jun 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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 43-557411-081 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Kansas City, KS 66160-8500

Mailing address

3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone (913) 588-3316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160720002038 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446543912 Reassigns benefits to 1 organization
I20240709003093 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446543912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

2930 N Stanton St
El Paso, TX 79902-2511
Phone (915) 271-4569

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43-557411-081KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Jun 25, 2024 Accepting new patients
BHS Physicians Network, Inc CurrentSince Jun 25, 2024 Accepting new patients

Locations

1625 Medical Center Dr
El Paso, TX 79902
Phone (915) 577-7746

2930 N Stanton St
El Paso, TX 79902
Phone (915) 271-4569

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

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, 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": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1275982126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADJALIMBE",
        "first_name": "KOMLA",
        "middle_name": "WELLA",
        "credential": "C.R.N.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "43-557411-081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; 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.