Individual provider Active NPI

Keaton William Todd, DNAP

  • Certified Registered Nurse Anesthetist
  • Joplin, MO
National Provider Identifier
1629637038
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
123880 Issued in MO
Practice address
1102 W 32ND St
Joplin, MO 64804-3503
Phone
(417) 347-1111
NPI assigned
Jun 10, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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 123880 MO Primary

Addresses

Primary practice location

1102 W 32ND St
Joplin, MO 64804-3503

Mailing address

1115 Valleyview LN
Joplin, MO 64804-3543
Phone (417) 818-8387

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190816000920 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577890334 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Missouri LLCGroup PAC ID 4082908249, 88 clinicians
Ozark Anesthesia Associates IncGroup PAC ID 1850290149, 86 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 556-3729

1500 N Oakland Ave
Citizens Memorial Hospital
Bolivar, MO 65613-3011
Phone (417) 326-6000

3801 S National Ave
Springfield, MO 65807-5210
Phone (417) 269-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
123880MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Anesthesia Associates, Inc. Anesthesiology CurrentSince Nov 1, 2021 Accepting new patients

Locations

3535 S National Ave
Springfield, MO 65807
Phone (417) 269-9767

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

1000 E Primrose St
Ste 520
Springfield, MO 65807
Phone (417) 269-4557

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1629637038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 VALLEYVIEW LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043543",
            "telephone_number": "417-818-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043503",
            "telephone_number": "417-347-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "KEATON",
        "middle_name": "WILLIAM",
        "credential": "DNAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "123880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.