Individual provider Active NPI

Katie Justine Korneman, CRNA

  • Certified Registered Nurse Anesthetist
  • Merriam, KS
National Provider Identifier
1639934821
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95002657 Issued in CA
Practice address
9100 W 74TH St
Merriam, KS 66204-4004
Phone
(913) 676-2000
NPI assigned
Feb 16, 2024
Last updated
Jun 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2026000994 MO
Certified Registered Nurse Anesthetist 367500000X 43-558377-021 KS
Certified Registered Nurse Anesthetist 367500000X 95002657 CA Primary

Addresses

Primary practice location

9100 W 74TH St
Merriam, KS 66204-4004

Mailing address

117 W 20TH St Apt 707
Kansas City, MO 64108-2087

Other practice location 1

2700 Clay Edwards Dr Ste 240
North Kansas City, MO 64116-3254
Phone (816) 691-2021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MO, KS3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20251120003694 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113419870 Reassigns benefits to 1 organization
I20260416000629 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113419870 Reassigns benefits to 1 organization
I20260518003158 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113419870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Anesthesia Associates, PAGroup PAC ID 4981597838, 89 clinicians

Practice addresses (Care Compare)

2295 S Vineyard Ave
Ontario, CA 91761-7925
Phone (909) 724-5000

9100 W 14TH St
Shawnee Mission, KS 66204-4004
Phone (913) 632-2230

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95002657CAMDCertified Registered Nurse Anesthetist
43-558377-021KSMDCertified Registered Nurse Anesthetist
2026000994MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 7, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 7, 2025 Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

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.

Hospital & facility affiliations 3

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": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1639934821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W 20TH ST APT 707",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Clay Edwards Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163254",
            "country_code": "US",
            "telephone_number": "816-691-2021",
            "fax_number": "816-346-7690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNEMAN",
        "first_name": "KATIE",
        "middle_name": "JUSTINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2026000994",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "43-558377-021",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merriam, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.