Individual provider Active NPI

Vicki L Roe, CRNA

  • Certified Registered Nurse Anesthetist
  • Wichita, KS
National Provider Identifier
1447547443
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
557042 Issued in KS
Practice address
929 N Saint Francis St
Wichita, KS 67214-3821
Phone
(316) 268-5000
Fax
(316) 291-4272
NPI assigned
Jun 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1351358081 KS
Student in an Organized Health Care Education/Training Program 390200000X 1351358081 KS
Certified Registered Nurse Anesthetist 367500000X 557042 KS Primary

Addresses

Primary practice location

929 N Saint Francis St
Wichita, KS 67214-3821

Mailing address

PO Box 2897
Wichita, KS 67201-2897
Phone (800) 374-5326

Other identifiers 2

IdentifierTypeStateIssuer
P01012062OtherKSRR MEDICARE
200741790AMedicaidKS

Other names 1

  • Vicki L Guetersloh Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120106000609 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143496455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consulting Services, PAGroup PAC ID 7214849710, 75 clinicians

Practice addresses (Care Compare)

929 N Saint Francis Ave
Wichita, KS 67214-3821
Phone (316) 268-5000

Hospital & facility affiliations

  • Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1351358081KSMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Consulting Services, PA CurrentSince Oct 3, 2011 Accepting new patients
Heartland Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

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 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": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1447547443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2897",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672012897",
            "telephone_number": "800-374-5326",
            "fax_number": "800-374-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 N SAINT FRANCIS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143821",
            "telephone_number": "316-268-5000",
            "fax_number": "316-291-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROE",
        "first_name": "VICKI",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "1351358081",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KS",
            "license": "1351358081",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "557042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01012062",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200741790A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKI",
            "last_name": "GUETERSLOH",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; 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.