Individual provider Active NPI

Anna Mae Cowgur, CRNA

  • Certified Registered Nurse Anesthetist
  • Gravette, AR
National Provider Identifier
1457510877
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C02714 Issued in AR
Practice address
1101 Jackson St SW
Gravette, AR 72736-9121
Phone
(479) 787-5291
Fax
(479) 344-6404
NPI assigned
Jun 2, 2008
Last updated
Jun 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X C02714 AR Primary

Addresses

Primary practice location

1101 Jackson St SW
Gravette, AR 72736-9121

Mailing address

PO Box 507
Lowell, AR 72745-0507
Phone (913) 642-4900

Other practice location 1

2710 Rife Medical Ln
Anesthesia Dept
Rogers, AR 72758-1452
Phone (913) 642-4900 ext. 247

Other identifiers 2

IdentifierTypeStateIssuer
5V088OtherARBCBSAR
174709001MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081027000789 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547328072 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sgoh Acquisition IncGroup PAC ID 5092616276, 95 clinicians

Practice addresses (Care Compare)

1101 Jackson St SW
Gravette, AR 72736-9121
Phone (479) 787-5291

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C02714ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services of Benton County PA CurrentSince Jul 20, 2008 Accepting new patients
Capital Anesthesia Solutions of Arkansas, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 18, 2023 Accepting new patients
Sgoh Acquisition Inc CurrentSince Feb 20, 2020 Accepting new patients
Sgoh Acquisition Inc CurrentSince Feb 20, 2020 Accepting new patients

Locations

3000 Medical Center Pkwy
Fl 2
Bentonville, AR 72712

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1457510877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 507",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450507",
            "telephone_number": "913-642-4900",
            "fax_number": "913-381-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST SW",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369121",
            "telephone_number": "479-787-5291",
            "fax_number": "479-344-6404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2710 Rife Medical Ln",
            "address_2": "ANESTHESIA DEPT",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727581452",
            "country_code": "US",
            "telephone_number": "913-642-4900 x247",
            "fax_number": "913-381-0979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COWGUR",
        "first_name": "ANNA",
        "middle_name": "MAE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "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": "C02714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAR",
            "identifier": "5V088",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174709001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gravette, 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.