Active NPI
Kimberly L. Redman, CRNA
- Certified Registered Nurse Anesthetist
- Rolla, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2010034566
- Practice address
- 1605 Martin Springs Dr
Rolla, MO 65401-2931 - Phone
- (417) 533-6010
- Fax
- (417) 533-6173
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2001004539 | MO | |
| Certified Registered Nurse Anesthetist | 367500000X | 2010034566 | MO | Primary |
Addresses
Primary practice location
1605 Martin Springs Dr
Rolla, MO 65401-2931
Mailing address
PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431560263 | Other | TRICARE | |
| 1366510448 | Medicaid | MO | |
| 970019029 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 553-6059
1605 Martin Springs Dr
Rolla, MO 65401-2980
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001004539 | MO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Hospital Lebanon | Current | Accepting new patients |
Locations
100 Hospital Dr
Lebanon, MO 65536
Phone (417) 533-6010
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
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 and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- Family Medicine Physician
- Hollister, MO
- NPI 1053350454
-
- General Acute Care Hospital
- Lebanon, MO
- NPI 1447284898
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lebanon, MO
- NPI 1447284898
-
- General Acute Care Hospital
- Rolla, MO
- NPI 1740413988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1366510448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2580",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658012580",
"telephone_number": "417-829-4620",
"fax_number": "417-829-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 MARTIN SPRINGS DR",
"city": "ROLLA",
"state": "MO",
"postal_code": "654012931",
"telephone_number": "417-533-6010",
"fax_number": "417-533-6173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDMAN",
"first_name": "KIMBERLY",
"middle_name": "L.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2001004539",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2010034566",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "431560263",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1366510448",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "970019029",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rolla, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.