Individual provider Active NPI

Christina Azzam, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Charles, MO
National Provider Identifier
1487074357
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2014011357 Issued in MO
Practice address
300 1St Capitol Dr
Saint Charles, MO 63301-2844
Phone
(314) 775-2816
NPI assigned
Apr 18, 2014
Last updated
Nov 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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 2014011357 MO Primary

Addresses

Primary practice location

300 1St Capitol Dr
Saint Charles, MO 63301-2844

Mailing address

400 S Woods Mill Rd Ste 140
Chesterfield, MO 63017-3427
Phone (314) 485-1101

Other names 1

  • Christina Cross Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140625002394 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971728411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-West Anesthesia Partners LLCGroup PAC ID 1557842911, 42 clinicians
Metro-West Anesthesia Group IncGroup PAC ID 2163329921, 204 clinicians

Practice addresses (Care Compare)

1130 Town and Country Commons Dr
Town and Country, MO 63017-8200
Phone (636) 256-0320

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone (314) 453-0600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014011357MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro-West Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince May 17, 2014 Accepting new patients

Locations

13515 Barrett Parkway Dr
Ste 170
Ballwin, MO 63021
Phone (314) 775-2811

400 S Woods Mill Rd
Ste 140
Chesterfield, MO 63017
Phone (314) 485-1101

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1487074357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S WOODS MILL RD STE 140",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173427",
            "telephone_number": "314-485-1101",
            "fax_number": "314-485-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 1ST CAPITOL DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012844",
            "telephone_number": "314-775-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZAM",
        "first_name": "CHRISTINA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2014011357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "CROSS",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.