Individual provider Active NPI

Gina Newberry, CRNA

  • Certified Registered Nurse Anesthetist
  • Bridgeton, MO
National Provider Identifier
1386008035
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2009030293 Issued in MO
Practice address
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone
(469) 757-1042
Fax
(855) 917-2066
NPI assigned
Apr 8, 2016
Last updated
Jan 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2009030293 MO Primary

Addresses

Primary practice location

12303 De Paul Dr
Bridgeton, MO 63044-2512

Mailing address

13515 Barrett Parkway Dr
Suite 170
Ballwin, MO 63021-5870
Phone (469) 757-1042

Other names 1

  • Gina Butler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160512001687 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002105111 Reassigns benefits to 1 organization
I20241101001025 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002105111 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
Divine Savior Healthcare IncGroup PAC ID 5799684007, 135 clinicians

Practice addresses (Care Compare)

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.7 of 100Reported as group
Quality
91.14
Promoting interoperability
100
Improvement activities
40
Cost
77.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009030293MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Savior Healthcare, Inc. CurrentSince Nov 18, 2024 Accepting new patients
Metro-West Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince May 9, 2016 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Nov 18, 2024 Accepting new patients
Mid-West Anesthesia Partners, LLC PastSince Dec 7, 2025 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

13515 Barrett Parkway Dr
Ste 170
Ballwin, MO 63021
Phone (314) 775-2811

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

400 S Woods Mill Rd
Ste 140
Chesterfield, MO 63017
Phone (314) 485-1101

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1386008035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13515 BARRETT PARKWAY DR",
            "address_2": "SUITE 170",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630215870",
            "telephone_number": "469-757-1042",
            "fax_number": "855-917-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442512",
            "telephone_number": "469-757-1042",
            "fax_number": "855-917-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "GINA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2009030293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "BUTLER",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.