Midwest Anesthesia Providers S.C
Organization Active NPI Anesthesiology Physician · Saint Louis, MO
NPI 1295189082 · NPPES record last updated Feb 18, 2022
Key facts
- NPI
- 1295189082
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- MIDWEST ANESTHESIA PROVIDERS S.C
- Practice address
- 11133 Dunn Rd
Saint Louis, MO 63136-6163 - Phone
- (865) 293-5676
- NPI assigned
- Apr 18, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Mark Gordon, MD
- Title
- President
- Phone
- (865) 293-5676
Practitioners 428
-
Jeffrey Alexander, D.O.
-
Sethabel L Alvarado, M.D.
-
Yousra Amor, CRNA
-
Eric J. W. Bader, D.O.
-
Sean Vincent Baxter, CRNA
-
Brian William Bennett, CRNA
-
Neal Brunkhorst, CRNA
-
Cassandra Decker, CRNA
-
Ronald Travis Donaldson, CRNA
-
Daniel Dozier Jr., C-AA
-
Rachel Ann Evans, CRNA
-
Rachel M Findeiss, CRNA
-
Lawrence W Fournier Jr., CRNA
-
Lindsey A Freeman, CRNA
-
Amanuel Zewdu Gebeyehu, CRNA
-
Jesse Graham Gibbons, AA-C
-
Natasha Renee Goodwin, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160628000182 | IL | Part B Supplier - Clinic/Group Practice | 9830480581 |
Receives reassigned benefits from 251 practitioners Practice locations: Alton, IL; Belleville, IL; Shiloh, IL |
| O20160712001846 | MO | Part B Supplier - Clinic/Group Practice | 9830480581 |
Receives reassigned benefits from 221 practitioners Practice locations: Farmington, MO; Saint Louis, MO; Saint Peters, MO; Sullivan, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Pain Medicine (Anesthesiology) Physician |
207LP2900X | |||
| Certified Registered Nurse Anesthetist |
367500000X | |||
| Anesthesiologist Assistant |
367H00000X |
Addresses
Primary practice location
11133 Dunn Rd
Saint Louis, MO 63136-6163
Mailing address
1431 Centerpoint Blvd Ste 100
Knoxville, TN 37932-1983
Other providers in Saint Louis, MO
- Midwest Acute Care Consultants, PC
- Midwest Anesthesia
- Midwest Anesthesia Associates, P.C.
- Midwest Anesthesia Inc.
- Midwest Anesthesia LLC
- Midwest Behavioral Health and Wellness
- Midwest Bone & Joint Surgery
- Midwest Bone & Joint Surgery PC
- Midwest Cardiovascular Center, LLC
- Midwest Cardiovascular, Inc.
All providers in Saint Louis, MO · Anesthesiology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.