Individual provider Active NPI

Connor Anderl, CRNA

  • Certified Registered Nurse Anesthetist
  • Ogden, UT
National Provider Identifier
1437160645
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
317095-4406 Issued in UT
Practice address
5475 S 500 E
Ogden, UT 84405-6905
Phone
(800) 880-3566
Fax
(801) 733-5872
NPI assigned
Aug 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 317095-4406 UT Primary

Addresses

Primary practice location

5475 S 500 E
Ogden, UT 84405-6905

Mailing address

246 E 1050 N
Kaysville, UT 84037-1249
Phone (801) 476-7168

Other identifiers 4

IdentifierTypeStateIssuer
TPRA07565OtherUTMOLINA
219506OtherUTALTIUS
59968OtherUTHEALTHY U
68295OtherUTPEHP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041110000942 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698738607 Reassigns benefits to 3 organizations
I20180619002790 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698738607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NPH Anesthesia of Utah LLCGroup PAC ID 9537584313, 91 clinicians

Practice addresses (Care Compare)

5475 S 500
Ogden, UT 84405-6905
Phone (469) 998-7443

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
317095-4406UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Anesthesia LC CurrentSince Oct 16, 2019 Accepting new patients
NPH Anesthesia of Utah, LLC CurrentSince Feb 1, 2022 Accepting new patients
South Towne Anesthesia LLC CurrentSince Mar 9, 2023 Accepting new patients
CMSC, LLC CurrentSince May 29, 2018 Accepting new patients

Locations

1509 29th St S
Great Falls, MT 59405
Phone (406) 771-3500

3010 15th Ave S
Great Falls, MT 59405
Phone (406) 771-3095

4100 International Plz
Ste 800
Ft Worth, TX 76109
Phone (855) 373-6862

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

96 E Kimballs Ln
Draper, UT 84020
Phone (801) 233-9300

96 E Kimballs Ln
Ste 100
Draper, UT 84020
Phone (801) 233-9300

1954 E Fort Union Blvd
Ste 105
Salt Lake Cty, UT 84121
Phone (801) 993-9524

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437160645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 E 1050 N",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371249",
            "telephone_number": "801-476-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 S 500 E",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056905",
            "telephone_number": "800-880-3566",
            "fax_number": "801-733-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERL",
        "first_name": "CONNOR",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "317095-4406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "TPRA07565",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "219506",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY U",
            "identifier": "59968",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "68295",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.