Individual provider Active NPI

Karen Roof, CRNA

  • Certified Registered Nurse Anesthetist
  • Springfield, IL
National Provider Identifier
1396162947
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209021852 Issued in IL
Practice address
800 E Carpenter St
Springfield, IL 62769-2329
Phone
(217) 544-6464
Fax
(217) 757-6537
NPI assigned
Mar 20, 2014
Last updated
Aug 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 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 209021852 IL Primary

Addresses

Primary practice location

800 E Carpenter St
Springfield, IL 62769-2329

Mailing address

800 E Carpenter St
Springfield, IL 62769-1000
Phone (217) 544-6464

Other practice location 1

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5330

Other identifiers 1

IdentifierTypeStateIssuer
2014012665OtherMONURSE ANESTHETIST LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140624000636 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305060831 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-America Anesthesia Consultants PCGroup PAC ID 6305837626, 49 clinicians

Practice addresses (Care Compare)

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-5511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209021852ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-America Anesthesia Consultants, PC CurrentSince Aug 1, 2024 Accepting new patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2022 Accepting new patients
Southeast Missouri Hospital Physicians, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 22, 2021 Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1600 E Broadway
Ste 60
Columbia, MO 65201

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

100 Entrance Way
Saint Peters, MO 63376
Phone (363) 916-7140

114 Piper Hill Dr
Ste 101
Saint Peters, MO 63376
Phone (636) 706-0560

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1396162947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627691000",
            "telephone_number": "217-544-6464",
            "fax_number": "217-757-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627692329",
            "telephone_number": "217-544-6464",
            "fax_number": "217-757-6537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 N Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312329",
            "country_code": "US",
            "telephone_number": "314-996-5330",
            "fax_number": "314-997-0384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROOF",
        "first_name": "KAREN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209021852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE ANESTHETIST LICENSE",
            "identifier": "2014012665",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.