Individual provider Active NPI

Phillip J Zappa, CRNA

  • Certified Registered Nurse Anesthetist
  • Mountain Home, AR
National Provider Identifier
1629027446
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C01180 Issued in AR
Practice address
624 Hospital Dr
Mountain Home, AR 72653-2955
Phone
(870) 424-1000
Fax
(870) 424-6616
NPI assigned
May 9, 2006
Last updated
Apr 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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 C01180 AR Primary

Addresses

Primary practice location

624 Hospital Dr
Mountain Home, AR 72653-2955

Mailing address

PO Box 1269
Mountain Home, AR 72654-1269
Phone (870) 424-7070

Other identifiers 1

IdentifierTypeStateIssuer
155342701MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140408001505 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517939663 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C01180ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Kansas City PA CurrentSince Dec 18, 2019 Accepting new patients
Great Plains of Republic Co., Inc. CurrentSince Jan 1, 2026 Accepting new patients
Great Plains of Republic Co., Inc. Current Accepting new patients
Great Plains of Republic Co., Inc. CurrentSince Jan 1, 2026 Accepting new patients
Hamilton County Hospital Current Accepting new patients
Baxter County Regional Hospital Inc Past Accepting new patients
River Valley Anesthesia Associates, P. a. Past Accepting new patients
Mitchell County Hospital Health Systems Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Great Plains of Republic Co., Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2420 G St
Belleville, KS 66935
Phone (785) 527-2254

10601 Quivira Rd
Ste 100
Overland Park, KS 66215
Phone (913) 541-8897

10730 Nall Ave
Ste 100
Overland Park, KS 66211
Phone (913) 428-9000

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

Organizations & group practices 10

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1629027446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1269",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726541269",
            "telephone_number": "870-424-7070",
            "fax_number": "870-424-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 HOSPITAL DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532955",
            "telephone_number": "870-424-1000",
            "fax_number": "870-424-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAPPA",
        "first_name": "PHILLIP",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C01180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155342701",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.