Nathan Micklautz, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2023024701 Issued in MO

Practice address

1000 W 10TH St
Rolla, MO 65401-2905

Phone

(573) 458-8899

NPI assigned

Jun 23, 2023

Last updated

Jul 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phelps County Regional Medical CenterGroup PAC ID 2860391158, 111 clinicians

Midwest Anesthesia Providers SCGroup PAC ID 9830480581, 180 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Midwest Anesthesia Providers S.C

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1295189082

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Phelps County Regional Medical Center

  dba Phelps Health

  • General Acute Care Hospital
  • Rolla, MO
  • NPI 1891766051
  Medicare reassignment Care Compare group NPD
• Phelps County Regional Medical Center

  dba Phelps Health Medical Group

  • Rural Health Clinic/Center
  • Rolla, MO
  • NPI 1366066037
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Phelps County Regional Medical Center

  dba Phelps Health Medical Group

  • Rural Health Clinic/Center
  • Salem, MO
  • NPI 1194077701

  Hospital

  Care Compare affiliation
• Phelps County Regional Medical Center

  dba Phelps Health

  • Rehabilitation Hospital Unit
  • Rolla, MO
  • NPI 1346287455
  Care Compare affiliation
• Phelps County Regional Medical Center

  dba Phelps Health

  • General Acute Care Hospital
  • Rolla, MO
  • NPI 1891766051
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1326724410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "735-458-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-458-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLAUTZ",
        "first_name": "NATHAN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2023024701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercy Hospital Springfield (Mercy Medical Supply)
• Mercy Hospital Springfield (Mercy Pharmacy-Rolla)
• Mercy Pharmacy Services, LLC (Mercy Pharmacy Rolla)
• Derrick Meyers, PHD, BA
• Mi Serenity
• Mid-Missouri Foot and Ankle Center (Anderson Foot Clinic)
• Mid-Missouri Internal Medicine Inc
• Mid-Mo O&P LLC (Hitek Limb and Brace)
• Angela Christine Middleton, FNP-BC, CEN
• Midwest Chiropractic Center LLC

• Certified Registered Nurse Anesthetist in Rolla, MO
• Providers in Rolla, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; 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.