Individual provider Active NPI

Kallie Chapman Beretta, CRNA

  • Certified Registered Nurse Anesthetist
  • Phenix City, AL
National Provider Identifier
1306465935
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-149837 Issued in AL
Practice address
4401 Riverchase Dr
Phenix City, AL 36867-7483
Phone
(334) 732-3000
NPI assigned
Apr 14, 2020
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 8423336 NV
Certified Registered Nurse Anesthetist 367500000X 26463 SC
Certified Registered Nurse Anesthetist 367500000X RN2339414 MA
Certified Registered Nurse Anesthetist 367500000X APRN-195940 MT
Certified Registered Nurse Anesthetist 367500000X 1-149837 AL Primary

Addresses

Primary practice location

4401 Riverchase Dr
Phenix City, AL 36867-7483

Mailing address

224 Jasmine Hill Rd
Indian Springs, AL 35124-3328
Phone (334) 202-5596

Other practice location 1

759 Chestnut St
Springfield, MA 01199-1001
Phone (334) 202-5596

Other practice location 2

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-3271

Other practice location 3

115 Cass Ave
Woonsocket, RI 02895-4705
Phone (850) 985-9180

Other identifiers 1

IdentifierTypeStateIssuer
110164311AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, GA, AL, MT, RI5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20200724000658 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335563204 Reassigns benefits to 1 organization
I20230502000912 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335563204 Reassigns benefits to 1 organization
I20230525002196 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335563204 Reassigns benefits to 2 organizations
I20240814001477 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335563204 Reassigns benefits to 4 organizations
I20250613000975 RI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335563204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

115 Cass Ave
Woonsocket, RI 02895-4705
Phone (401) 769-4100

2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-149837ALMDCertified Registered Nurse Anesthetist
RN2339414MAMDCertified Registered Nurse Anesthetist
APRN-195940MTMDCertified Registered Nurse Anesthetist
8423336NVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Anesthesia Service, Inc. CurrentSince Aug 17, 2020 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Apr 25, 2023 Accepting new patients
Amsol Anesthetists of Georgia LLC-Hughston Surgical Center Nurse Anesthetist, Certified Registered CurrentSince May 1, 2023 Accepting new patients
Crna Services of DGH Nurse Anesthetist, Certified Registered CurrentSince Aug 19, 2024 Accepting new patients
Billings Clinic Current Accepting new patients
Billings Clinic CurrentSince Aug 6, 2024 Accepting new patients
Billings Clinic CurrentSince Aug 6, 2024 Accepting new patients
The Surgery Center at Self Memorial Hospital, LLC CurrentSince Oct 1, 2022 Accepting new patients
Amsol Anesthetists of Georgia, LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2023 Accepting new patients
Starlyn Green Inc. Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2025 Accepting new patients
Clinical Colleagues LLC Nurse Anesthetist, Certified Registered CurrentSince May 20, 2025 Accepting new patients
Medical Eye Specialists PC PastSince Jul 26, 1997 Accepting new patients
HH Health System-Morgan Inc. Past Accepting new patients

Locations

1201 7th St SE
Decatur, AL 35601
Phone (256) 341-2000

4401 Riverchase Dr
Phenix City, AL 36867
Phone (334) 732-3000

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

908 Allen St
Springfield, MA 01118
Phone (413) 732-5139

181 Park Ave
Ste 5
West Springfield, MA 01089
Phone (413) 795-7494

400 10th St E
Waconia, MN 55387

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

3820 N 27th Ave
Ste 100
Bozeman, MT 59718
Phone (406) 587-1245

320 Alpenglow Ln
Livingston, MT 59047
Phone (406) 222-3541

115 Cass Ave
Woonsocket, RI 02895
Phone (401) 356-1701

101 Academy Ave
Greenwood, SC 29646
Phone (864) 227-8242

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 10

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": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1306465935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 JASMINE HILL RD",
            "city": "INDIAN SPRINGS",
            "state": "AL",
            "postal_code": "351243328",
            "telephone_number": "334-202-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 RIVERCHASE DR",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677483",
            "telephone_number": "334-732-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011991001",
            "country_code": "US",
            "telephone_number": "334-202-5596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-3271",
            "fax_number": "508-856-5911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Cass Ave",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028954705",
            "country_code": "US",
            "telephone_number": "850-985-9180",
            "fax_number": "765-588-1485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERETTA",
        "first_name": "KALLIE",
        "middle_name": "CHAPMAN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NV",
            "license": "8423336",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "26463",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2339414",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "APRN-195940",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-149837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110164311A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phenix City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.