Individual provider Active NPI

Nancy L Skinker, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
National Provider Identifier
1649296955
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
105331 Issued in MO
Practice address
12634 Olive Blvd
Saint Louis, MO 63141-6337
Phone
(314) 996-8000
Fax
(314) 996-8479
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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 105331 MO Primary

Addresses

Primary practice location

12634 Olive Blvd
Saint Louis, MO 63141-6337

Mailing address

C B 8221
7425 Forsyth
Saint Louis, MO 63105-2161
Phone (314) 996-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060329000196 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668480997 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105331MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 16, 2006 Accepting new patients
Ambulatory Anesthesia Services of St. Charles, LLC CurrentSince Oct 16, 2017 Accepting new patients

Locations

14825 North Outer 40 Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 898-4695

4203 S Cloverleaf Dr
Saint Peters, MO 63376
Phone (636) 346-6051

1130 Town and Country Commons Dr
Twn and Cntry, MO 63017
Phone (636) 256-0320

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1649296955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C B 8221",
            "address_2": "7425 FORSYTH",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052161",
            "telephone_number": "314-996-8000",
            "fax_number": "314-996-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12634 OLIVE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416337",
            "telephone_number": "314-996-8000",
            "fax_number": "314-996-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINKER",
        "first_name": "NANCY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "105331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.