Individual provider Active NPI

Stan D Avery, CRNA

  • Certified Registered Nurse Anesthetist
  • Lee's Summit, MO
National Provider Identifier
1578705703
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
102966 Issued in MO
Practice address
100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone
(816) 347-5000
Fax
(816) 347-5045
NPI assigned
Apr 2, 2009
Last updated
Apr 2, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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 102966 MO Primary

Addresses

Primary practice location

100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000

Mailing address

10310 State Line Rd
Suite a
Leawood, KS 66206-2658
Phone (913) 647-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091002000154 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123164290 Reassigns benefits to 1 organization
I20251218003161 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123164290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes East Anesthesia Services PCGroup PAC ID 1850333477, 44 clinicians
Lawrence Anaesthesia PAGroup PAC ID 6709776172, 34 clinicians

Practice addresses (Care Compare)

100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone (816) 347-5097

120 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone (816) 347-5800

613 N 2ND St
Lawrence, KS 66044-1407
Phone (785) 842-7026

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence Anaesthesia PA CurrentSince Jan 1, 2026 Accepting new patients
St Lukes East Anesthesia Services,P.C. CurrentSince Aug 29, 2009 Accepting new patients

Locations

613 N 2nd St
Lawrence, KS 66044
Phone (785) 842-7026

10310 State Line Rd
Ste A
Leawood, KS 66206
Phone (913) 647-4101

100 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5097

120 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5800

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 2

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": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238630400000",
    "number": "1578705703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10310 STATE LINE RD",
            "address_2": "SUITE A",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662062658",
            "telephone_number": "913-647-4100",
            "fax_number": "913-647-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE SAINT LUKES BLVD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866000",
            "telephone_number": "816-347-5000",
            "fax_number": "816-347-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "STAN",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-02",
        "last_updated": "2009-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "102966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; 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.