Individual provider Active NPI

Cassandra Maureen Beaumont, CRNA

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
National Provider Identifier
1417577420
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
125971 Issued in AR
Practice address
2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone
(501) 552-3000
NPI assigned
Apr 20, 2020
Last updated
Jun 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 125971 AR Primary
Registered Nurse 163W00000X R099882 AR

Addresses

Primary practice location

2 Saint Vincent Cir
Little Rock, AR 72205-5423

Mailing address

500 S University Ave Ste 500
Little Rock, AR 72205-5307
Phone (501) 664-4532

Other names 1

  • Cassandra Maureen White Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200707000384 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113340399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Anesthesia Associates PLLCGroup PAC ID 6406023142, 85 clinicians

Practice addresses (Care Compare)

1 Medical Park Dr
Benton, AR 72015-3353
Phone (501) 776-6000

1701 S Shackleford Rd
Little Rock, AR 72211-4335
Phone (501) 219-7000

1901 Encore Way
Bryant, AR 72019-8896
Phone (501) 326-6868

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R099882ARMDRegistered Nurse
125971ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Anesthesia Associates, PLLC. CurrentSince Jul 18, 2022 Accepting new patients
Southern Regional Anesthesiology Consultants PLLC CurrentSince Jun 30, 2020 Accepting new patients

Locations

10301 Kanis Rd
Little Rock, AR 72205
Phone (501) 604-4151

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

500 S University Ave
Ste 500
Little Rock, AR 72205
Phone (501) 320-1101

4 Hospital Dr
Morrilton, AR 72110
Phone (501) 977-2300

Organizations & group practices 2

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 4

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": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1417577420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE STE 500",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055307",
            "telephone_number": "501-664-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SAINT VINCENT CIR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055423",
            "telephone_number": "501-552-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUMONT",
        "first_name": "CASSANDRA",
        "middle_name": "MAUREEN",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "125971",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R099882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "WHITE",
            "middle_name": "MAUREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.