Theodore Frank Collier, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Monett, MO
NPI 1609977677 · NPPES record last updated Oct 28, 2019
Key facts
- NPI
- 1609977677
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 2001004740 (MO)
- Practice address
- 801 N Lincoln Ave
Monett, MO 65708-1641 - Phone
- (417) 235-3144
- Fax
- (417) 354-1412
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DCHD Health Care Professionals LLC
Practice addresses (Care Compare)
900 N Robert Ave
Arcadia, FL 34266-8712
Phone (863) 494-8426
Hospital & facility affiliations
- Desoto Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220322000781 | FL | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 7618902180 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004740 | MO | MD | Pediatric Occupational Therapist |
| 2001004740 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Care Anesthesia Specialists Inc | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| DCHD Health Care Professionals LLC | Current |
Accepting new patients | |
| Northland Anesthesiology Inc | Past | Accepting new patients |
Locations
900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426
1400 Education Way
Pt Charlotte, FL 33948
Phone (800) 771-7164
2500 Harbor Blvd
Pt Charlotte, FL 33952
Phone (941) 766-4122
18350 Murdock Cir
Unit 102
Pt Charlotte, FL 33948
Phone (941) 206-7251
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2001004740 | MO | Yes |
Addresses
Primary practice location
801 N Lincoln Ave
Monett, MO 65708-1641
Mailing address
PO Box 4046
Springfield, MO 65808-4046
Phone (417) 269-5712
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 917439705 | Medicaid | MO |
Other providers in Monett, MO
- Clark Community Mental Health Center
- Clark Community Mentalhealth Center
- Kelly Cochran
- Althia Cole
- Amy J Cole
- Jennifer Eleanor Conner
- Kathleen Josef Cook
- Nicole Coorts
- Clifford M. Costley
- Matt Costley
All providers in Monett, 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 Oct 28, 2019. 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.