Individual provider Active NPI

Kristofer Neale Warren

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1437556842
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3009236 Issued in KY
Practice address
320 Whittington Pkwy
Suite 320
Louisville, KY 40222-4928
Phone
(502) 625-5584
Fax
(502) 426-2264
NPI assigned
Dec 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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 3009236 KY Primary
Registered Nurse 163W00000X 1142478 KY

Addresses

Primary practice location

320 Whittington Pkwy
Suite 320
Louisville, KY 40222-4928

Mailing address

320 Whittington Pkwy
Suite 320
Louisville, KY 40222-4928
Phone (502) 625-5584

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161020001973 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577889906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Southern Illinois University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Anesthesiology Associates IncGroup PAC ID 6204720667, 251 clinicians

Practice addresses (Care Compare)

901 E 5TH St
Deptartment of Anesthesiology
Washington, MO 63090-3127
Phone (636) 239-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1142478KYMDRegistered Nurse
3009236KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro-West Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2019 Accepting new patients
Phelps County Regional Medical Center CurrentSince May 25, 2019 Accepting new patients
Phelps County Regional Medical Center CurrentSince May 25, 2019 Accepting new patients

Locations

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

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

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

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 and National Provider Directory roles.

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": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1437556842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WHITTINGTON PKWY",
            "address_2": "SUITE 320",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224928",
            "telephone_number": "502-625-5584",
            "fax_number": "502-426-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WHITTINGTON PKWY",
            "address_2": "SUITE 320",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224928",
            "telephone_number": "502-625-5584",
            "fax_number": "502-426-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "KRISTOFER",
        "middle_name": "NEALE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-01",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3009236",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1142478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.