Phyllis Knickerbocker, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1999137827 Issued in MO

Practice address

2727 McClelland Blvd
Joplin, MO 64804-1626

Phone

(417) 781-2727

Fax

(316) 652-0340

NPI assigned

Mar 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• St John'S Regional Medical Center

  • Anesthesiology Physician
  • Joplin, MO
  • NPI 1700032653

  Nurse Anesthetist, Certified Registered

  NPD (past)
• St Johns Regional Medical Center

  • Anesthesiology Physician
  • Joplin, MO
  • NPI 1841240546

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528035144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 760",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648020760",
            "telephone_number": "417-624-3040",
            "fax_number": "316-652-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 MCCLELLAND BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041626",
            "telephone_number": "417-781-2727",
            "fax_number": "316-652-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "PHYLLIS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "1999137827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "108602A",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Kimberly Klatt, D.O.
• Lindsay Dale Kloer, PA
• Philip Klonowski
• William Joseph Klontz, MD
• Michael Gerald Knapp, DO
• Connie Jean Knight, CNM
• Kaydan Lawson Knight, COTA/L
• John Knudsen III, MD
• Arooj Kohli, MD
• Madilyn Kolarik

• Certified Registered Nurse Anesthetist in Joplin, MO
• Providers in Joplin, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.