Individual provider Active NPI

Mary Kay Schmitt, CRNA

  • Certified Registered Nurse Anesthetist
  • High Ridge, MO
National Provider Identifier
1538150149
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
069856 Issued in MO
Practice address
2627 Wild Valley Dr
High Ridge, MO 63049-1563
Phone
(636) 677-1759
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 069856 MO Primary

Addresses

Primary practice location

2627 Wild Valley Dr
High Ridge, MO 63049-1563

Mailing address

13523 Barrett Parkway Dr
Suite 210
Ballwin, MO 63021-3802
Phone (314) 775-2816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
069856MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 16, 2006 Accepting new patients
Ambulatory Anesthesia Services of St. Charles, LLC CurrentSince Jul 29, 2017 Accepting new patients
Mercy Hospital Jefferson Past Accepting new patients
Advanced Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Midwest Anesthesia Inc. Past Accepting new patients
Eye Anesthesia LLC PastSince Jul 1, 2012 Accepting new patients

Locations

13523 Barrett Parkway Dr
Ste 210
Ballwin, MO 63021

14825 North Outer 40 Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 898-4695

4203 S Cloverleaf Dr
Saint Peters, MO 63376
Phone (636) 346-6051

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.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538150149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13523 BARRETT PARKWAY DR",
            "address_2": "SUITE 210",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630213802",
            "telephone_number": "314-775-2816",
            "fax_number": "314-775-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 WILD VALLEY DR",
            "city": "HIGH RIDGE",
            "state": "MO",
            "postal_code": "630491563",
            "telephone_number": "636-677-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITT",
        "first_name": "MARY",
        "middle_name": "KAY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "069856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Ridge, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.