Active NPI
Eric Vineyard, CRNA
- Certified Registered Nurse Anesthetist
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2017002831
- Practice address
- 10010 Kennerly Rd
Saint Louis, MO 63128-2106 - Phone
- (636) 386-3722
- Fax
- (636) 200-4036
- NPI assigned
- Feb 2, 2017
- 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 | 2017002831 | MO | Primary |
Addresses
Primary practice location
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Mailing address
PO Box 22407
Saint Louis, MO 63126-0407
Phone (636) 386-7222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170222001472 | MO | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6507140399 | Reassigns benefits to 3 organizations |
| I20210610000875 | IL | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6507140399 | 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
- South County Anesthesia Associates LTDMetro-West Anesthesia Group Inc
Practice addresses (Care Compare)
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1000
2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone (314) 453-0600
Hospital & facility affiliations
- SSM St Clare Health Center
- Mercy Hospital South
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017002831 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South County Anesthesia Associates, LTD | Current | Accepting new patients | |
| Aim Anesthesia LLC | Current | Accepting new patients | |
| Metro-West Anesthesia Group Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| South County Anesthesia Associates, LTD. | Current | Accepting new patients | |
| Anesthesia of Southern Illinois LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
2810 Frank Scott Pkwy W
Ste 716
Belleville, IL 62223
Phone (618) 355-0880
339 Consort Dr
Ballwin, MO 63011
Phone (636) 386-7222
3550 McKelvey Rd
Bridgeton, MO 63044
Phone 31474109114048
1101 W Gannon Dr
Festus, MO 63028
Phone (636) 931-5997
10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328
12639 Old Tesson Rd
Saint Louis, MO 63128
Phone (314) 446-0291
2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850
Organizations & group practices 5
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.
-
- Anesthesiology Physician
- Chesterfield, MO
- NPI 1245427335
MO, Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Belleville, IL
- NPI 1053662932
IL, Nurse Anesthetist, Certified Registered
-
- Pain Clinic/Center
- Wentzville, MO
- NPI 1114290749
Hospital & facility affiliations 2
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": "1485993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485993600000",
"number": "1306384094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22407",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631260407",
"telephone_number": "636-386-7222",
"fax_number": "636-200-4036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10010 KENNERLY RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631282106",
"telephone_number": "636-386-3722",
"fax_number": "636-200-4036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINEYARD",
"first_name": "ERIC",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-02",
"last_updated": "2017-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2017002831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.