Active NPI
Alex Michael Witcher, DNP, CRNA
- Certified Registered Nurse Anesthetist
- Carterville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2023043288
- Practice address
- 307 Pennsylvania Ave
Carterville, IL 62918 - Phone
- (256) 339-2637
- NPI assigned
- Aug 31, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.453211 | IL | |
| Anesthesiology Physician | 207L00000X | 114630 | IL | |
| Certified Registered Nurse Anesthetist | 367500000X | 2023043288 | MO | Primary |
Addresses
Primary practice location
307 Pennsylvania Ave
Carterville, IL 62918
Mailing address
307 Pennsylvania Ave
Carterville, IL 62918
Phone (256) 339-2637
Other practice location 1
One Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-2568
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114630 | Other | NBCRNA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MUDOCREFERRAL@direct.health.missouri.edu | Direct | Curators of the University of Missouri |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS, AL, MO
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4141
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.453211 | IL | MD | Registered Nurse |
| 114630 | IL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Curators of the University of Missouri | Current | Accepting new patients | |
| The Curators of the University of Missouri | Current | Accepting new patients | |
| Springfield Clinic LLP | Current | Accepting new patients | |
| Associated Anesthesiologists, SC | Anesthesiology | Current | Accepting new patients |
| USA Health Anesthesia Billing Services, LLC | Anesthesiology | Current | Accepting new patients |
| Perioperative Services of Mississippi, LLC | Anesthesiology | Current | Accepting new patients |
Locations
2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711
6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393
1025 S 6th St
Springfield, IL 62703
1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568
1100 Virginia Ave
Columbia, MO 65212
Phone (573) 882-2663
350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500
1225 N State St
Jackson, MS 39202
Phone (601) 292-4261
Interoperability endpoints
- alexwitcher@sfc.allscriptsdirect.net
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- Columbia, MO
- NPI 1235126921
-
- Anesthesiology Physician
- Jackson, MS
- NPI 1881123123
-
- Anesthesiology Physician
- Mobile, AL
- NPI 1629635818
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1023612082
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1215974415
-
- Durable Medical Equipment & Medical Supplies
- Columbia, MO
- NPI 1356963201
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jefferson City, MO
- NPI 1174597892
-
- General Acute Care Hospital
- Columbia, MO
- NPI 1699769901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709164800000",
"number": "1457879330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 PENNSYLVANIA AVE",
"city": "CARTERVILLE",
"state": "IL",
"postal_code": "62918",
"telephone_number": "256-339-2637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 PENNSYLVANIA AVE",
"city": "CARTERVILLE",
"state": "IL",
"postal_code": "62918",
"telephone_number": "256-339-2637"
}
],
"practiceLocations": [
{
"address_1": "One Hospital Dr",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MO",
"postal_code": "652120001",
"country_code": "US",
"telephone_number": "573-882-2568",
"fax_number": "855-903-0985",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WITCHER",
"first_name": "ALEX",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DNP, CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-31",
"last_updated": "2024-02-29",
"certification_date": "2024-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041.453211",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "114630",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2023043288",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NBCRNA",
"identifier": "114630",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
"affiliation": "Y",
"endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals",
"affiliationName": "Curators of the University of Missouri",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct",
"address_1": "One Hospital Dr",
"city": "Columbia",
"state": "MO",
"country_code": "US",
"postal_code": "652120001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Carterville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.