Individual provider Active NPI

David S Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Independence, MO
National Provider Identifier
1609969583
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
105291 Issued in MO
Practice address
4801 Cliff Ave
Suite 101 Eye Surgery Center the Cliffs
Independence, MO 64055
Phone
(816) 478-4400
Fax
(816) 478-8240
NPI assigned
Oct 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 105291 MO Primary
Certified Registered Nurse Anesthetist 367500000X 1492144101 KS

Addresses

Primary practice location

4801 Cliff Ave
Suite 101 Eye Surgery Center the Cliffs
Independence, MO 64055

Mailing address

4801 Cliff Ave
Suite 100 Admin
Independence, MO 64055
Phone (816) 478-1230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230220000361 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032008909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
1656 Anesthesia LLCGroup PAC ID 7012154255, 12 clinicians

Practice addresses (Care Compare)

1656 Medical Blvd
Suite 201
Naples, FL 34110-1423
Phone (239) 449-4945

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42030TXMDGeneral Practice Dentistry
1492144101KSMDCertified Registered Nurse Anesthetist
105291MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services Plus Inc. Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2023 Accepting new patients
1656 Anesthesia, LLC CurrentSince Dec 1, 2022 Accepting new patients
Anesthesia Associates of Kansas City PA Past Accepting new patients
Novamed Eye Surgery Center of Overland Park, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
St Lukes East Anesthesia Services,P.C. Past Accepting new patients

Locations

6241 Arc Way
Ste B
Fort Myers, FL 33966
Phone (239) 278-9955

1656 Medical Blvd
Ste 201
Naples, FL 34110
Phone (239) 431-5713

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609969583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 CLIFF AVE",
            "address_2": "SUITE 100 ADMIN",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64055",
            "telephone_number": "816-478-1230",
            "fax_number": "816-350-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 CLIFF AVE",
            "address_2": "SUITE 101 EYE SURGERY CENTER THE CLIFFS",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64055",
            "telephone_number": "816-478-4400",
            "fax_number": "816-478-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "105291",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "1492144101",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, 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.
  • 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.