Daureen K Bloodworth, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP127584 Issued in TX

Practice address

1755 Kirby Pkwy
Memphis, TN 38120-4398

Phone

(901) 725-5846

Fax

(901) 726-4827

NPI assigned

May 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Daureen L Kellum Former name

Medicare fee-for-service enrollment

Enrolled in TN, AR, TX, MO4 enrollments

Enrollment records 4

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Freeman-Oak Hill Health System 385 clinicians

North Arkansas Regional Medical Center 86 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Freeman Health System - Freeman West Hospital, Joplin, MO, CCN 260137
• North Arkansas Regional Medical Center Hospital, Harrison, AR, CCN 040017

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Freeman-Oak Hill Health System

  • Multi-Specialty Clinic/Center
  • Joplin, MO
  • NPI 1679517023

  MO

  Medicare reassignment Care Compare group NPD
• North Arkansas Regional Medical Center

  • General Acute Care Hospital
  • Harrison, AR
  • NPI 1275523912

  AR

  Medicare reassignment Care Compare group NPD
• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998

  TN

  Medicare reassignment NPD
• Hendrick Anesthesia Network

  • Specialist
  • Abilene, TX
  • NPI 1851394993

  TX

  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631

  MO

  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657

  MO

  Medicare reassignment NPD
• Northstar Anesthesia of Missouri, LLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1396191789

  MO, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ozark Anesthesia Associates, Inc.

  • Anesthesiology Physician
  • Springfield, MO
  • NPI 1831109586

  MO

  Medicare reassignment NPD
• Freeman-Oak Hill Health System

  • Ambulance
  • Anderson, MO
  • NPI 1043252646
  Care Compare group
• Freeman-Oak Hill Health System

  • Oxygen Equipment & Supplies (DME)
  • Neosho, MO
  • NPI 1063477800
  Care Compare group
• Freeman-Oak Hill Health System

  • Psychiatric Hospital Unit
  • Joplin, MO
  • NPI 1073627584
  Care Compare group
• Freeman-Oak Hill Health System

  • Rehabilitation Hospital Unit
  • Joplin, MO
  • NPI 1083728026
  Care Compare group

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

• Freeman-Oak Hill Health System

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Webb City, MO
  • NPI 1114394228

  Hospital

  Care Compare affiliation
• Freeman-Oak Hill Health System

  • General Acute Care Hospital
  • Joplin, MO
  • NPI 1265546048

  Hospital

  Care Compare affiliation
• North Arkansas Regional Medical Center

  • Land Ambulance
  • Harrison, AR
  • NPI 1013907682

  Hospital

  Care Compare affiliation
• North Arkansas Regional Medical Center

  • General Acute Care Hospital
  • Harrison, AR
  • NPI 1275523912

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659324341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1198",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796041198",
            "telephone_number": "325-670-4220",
            "fax_number": "325-670-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 KIRBY PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204398",
            "telephone_number": "901-725-5846",
            "fax_number": "901-726-4827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Pine St",
            "address_purpose": "LOCATION",
            "city": "Abilene",
            "state": "TX",
            "postal_code": "796012432",
            "country_code": "US",
            "telephone_number": "325-670-4220",
            "fax_number": "325-670-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOODWORTH",
        "first_name": "DAUREEN",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "11951",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP127584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00440722",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3935986",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00527025",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4134142",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAUREEN",
            "last_name": "KELLUM",
            "middle_name": "L",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.