Active NPI
Gina Newberry, CRNA
- Certified Registered Nurse Anesthetist
- Bridgeton, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2009030293
- 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, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, WI
Enrollment records 2
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
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 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2009030293 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Divine Savior Healthcare, Inc. | Current | Accepting new patients | |
| Metro-West Anesthesia Group Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Divine Savior Healthcare, Inc. | Current | Accepting new patients | |
| Mid-West Anesthesia Partners, LLC | Past | 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.
-
dba Aspirus Divine Savior Hospital
- General Acute Care Hospital
- Portage, WI
- NPI 1124083894
-
- Anesthesiology Physician
- Chesterfield, MO
- NPI 1245427335
Nurse Anesthetist, Certified Registered
-
dba Aspirus Portage Clinic
- Rural Health Clinic/Center
- Portage, WI
- NPI 1386154417
-
- Anesthesiology Physician
- Chesterfield, MO
- NPI 1851254304
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Aspirus Divine Savior Hospital
- General Acute Care Hospital
- Portage, WI
- NPI 1124083894
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"
}
]
}
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- New Beginnings Asset Management Company, LLC
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- Andrea Newport, CRNA
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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.