David S Johnson, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Independence, MO
NPI 1609969583 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609969583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 105291 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- 1656 Anesthesia LLC
Practice addresses (Care Compare)
1656 Medical Blvd
Suite 201
Naples, FL 34110-1423
Phone (239) 449-4945
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230220000361 | FL | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9032008909 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42030 | TX | MD | General Practice Dentistry |
| 1492144101 | KS | MD | Certified Registered Nurse Anesthetist |
Practice roles (5 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Services Plus Inc. | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| 1656 Anesthesia, LLC | Current |
Accepting new patients | |
| St Lukes East Anesthesia Services,P.C. | Past | Accepting new patients | |
| Novamed Eye Surgery Center of Overland Park, LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Anesthesia Associates of Kansas City PA | 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
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 105291 | MO | Yes |
| 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
Other providers in Independence, MO
- Jobone
- Joel M. Leibsohn, M.D., Inc
- Alicia Johnson
- Amanda S Johnson
- Amy Sue Johnson
- Dawn Renee Johnson
- Gemycah S Johnson
- Josiah David Johnson
- Justin Johnson
- Leigh Anne Johnson
All providers in Independence, MO · Certified Registered Nurse Anesthetist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.