Individual provider Active NPI

Benjamin Althuisius, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Leonard Wood, MO
National Provider Identifier
1669998530
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C003209 Issued in AR
Practice address
4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098
Phone
(573) 596-0417
NPI assigned
Aug 22, 2017
Last updated
Dec 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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 C003209 AR Primary

Addresses

Primary practice location

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098

Mailing address

103 Charleston Way
Saint Robert, MO 65584-7839
Phone (479) 747-2586

Other practice location 1

1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO, AK3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180202001647 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193085595 Reassigns benefits to 1 organization
I20200325003143 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193085595 Reassigns benefits to 2 organizations
I20260212002790 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193085595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 553-6059

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C003209ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Sep 1, 2020 Accepting new patients
Phelps County Regional Medical Center CurrentSince Sep 23, 2022 Accepting new patients
McKinley Orthopedic and Sports Medicine, LLC CurrentSince Jan 29, 2026 Accepting new patients
Ozark Anesthesia Associates, Inc. CurrentSince Feb 11, 2020 Accepting new patients
Phelps County Regional Medical Center CurrentSince Sep 23, 2022 Accepting new patients
Premier Anesthesia of Arkansas Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Jan 29, 2018 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Sep 1, 2020 Accepting new patients

Locations

3745 Geist Rd
Fairbanks, AK 99709
Phone (907) 456-1112

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

100 Hospital Dr
Lebanon, MO 65536
Phone (417) 533-6010

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

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

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

Organizations & group practices 7

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 2

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": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1669998530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CHARLESTON WAY",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655847839",
            "telephone_number": "479-747-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-0417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012905",
            "country_code": "US",
            "telephone_number": "573-458-8899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALTHUISIUS",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-22",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C003209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leonard Wood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.