Keanon Walker, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Galena, KS
NPI 1609250083 · NPPES record last updated Jul 15, 2015
Key facts
- NPI
- 1609250083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 557353 (KS)
- Practice address
- 444 Four States Dr
Suite 2
Galena, KS 66739-4324 - Phone
- (620) 783-4000
- Fax
- (620) 783-4188
- NPI assigned
- Jul 15, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Hospital Berryville
Four States Anesthesia Services LLC
Practice addresses (Care Compare)
214 Carter St
Berryville, AR 72616-4303
Phone (870) 423-3355
444 Four States Dr
Suite 2
Galena, KS 66739-4325
Phone (620) 783-4000
Hospital & facility affiliations
- Mercy Specialty Hospital Southeast Kansas
- Mercy Hospital Joplin
- Mercy Hospital Berryville
- Mercy Hospital Carthage
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MO, KS, AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150812009157 | MO | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9638484157 | Reassigns benefits to 5 organizations |
| I20150817000294 | KS | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9638484157 | Reassigns benefits to 1 organization |
| I20240319001859 | AR | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9638484157 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 557353 | KS | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospital Carthage | Current |
Accepting new patients | |
| Mercy Clinic Springfield Communities | Current |
Accepting new patients | |
| Anesthesia Associates of Joplin LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Mercy Hospital Berryville | Current |
Accepting new patients | |
| Capital Anesthesia Solutions of Arkansas, LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Mercy Clinic Springfield Communities | Current |
Accepting new patients | |
| Mercy Hospital Carthage | Current |
Accepting new patients |
Locations
3000 Medical Center Pkwy
Fl 2
Bentonville, AR 72712
214 Carter St
Berryville, AR 72616
Phone (870) 423-3355
3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050
603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000
3116 Medical Park Dr
Carthage, MO 64836
Phone (417) 358-7574
3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121
1531 E 32nd St
Ste 6
Joplin, MO 64804
Phone (417) 627-9699
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 557353 | KS | Yes |
Addresses
Primary practice location
444 Four States Dr
Suite 2
Galena, KS 66739-4324
Mailing address
444 Four States Dr
Suite 2
Galena, KS 66739-4324
Phone (620) 783-4000
Other providers in Galena, KS
- Three Amigos Apothecary LLC
- Paul W Toma
- Shannon Marie Vogt
- Terry L Vogt
- Linda L Vonwedell
- Allan Paul Weston
- Kelli Jo Youngblood
All providers in Galena, KS · Certified Registered Nurse Anesthetist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.