NPIMap

Organization Active NPI

Kirksville Anesthesia Associates, P.C.

  • Anesthesiology Physician
  • Kirksville, MO
National Provider Identifier
1669498085
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
KIRKSVILLE ANESTHESIA ASSOCIATES, P.C.
Practice address
800 W Jefferson St
Northeast Regional Medical Center
Kirksville, MO 63501-1443
Phone
(660) 785-1000
Fax
(660) 785-1237
NPI assigned
Jul 15, 2006
Last updated
Aug 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2008

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

Authorized official

Name
Melvin C. Roof, D.O.NPI 1770509549
Title
President
Phone
(660) 785-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

800 W Jefferson St
Northeast Regional Medical Center
Kirksville, MO 63501-1443

Mailing address

PO Box 702
Kirksville, MO 63501-0702
Phone (660) 785-1000

Other identifiers 6

IdentifierTypeStateIssuer
0976845MedicaidIA
503208209MedicaidMO
8298OtherMOHEALTHCARE USA
CG4336OtherRAILROAD MEDICARE
299013OtherBLACK LUNG
1205OtherBLUE CROSS, BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219276800000",
    "number": "1669498085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 702",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635010702",
            "telephone_number": "660-785-1000",
            "fax_number": "660-785-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W JEFFERSON ST",
            "address_2": "NORTHEAST REGIONAL MEDICAL CENTER",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635011443",
            "telephone_number": "660-785-1000",
            "fax_number": "660-785-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRKSVILLE ANESTHESIA ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-08-21",
        "status": "A",
        "authorized_official_last_name": "ROOF",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "660-785-1000",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0976845",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "503208209",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "8298",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG4336",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "299013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS, BLUE SHIELD",
            "identifier": "1205",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.