NPIMap

Organization Active NPI

Leavenworth Anesthesia PA

  • Certified Registered Nurse Anesthetist
  • Leavenworth, KS
National Provider Identifier
1679555262
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
LEAVENWORTH ANESTHESIA PA
Practice address
605 Shawnee St
Leavenworth, KS 66048-1958
Phone
(913) 680-0812
Fax
(913) 680-1445
NPI assigned
Nov 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mrs. Jean M Covillo, CRNANPI 1003898453
Title
President
Phone
(913) 680-0812

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

605 Shawnee St
Leavenworth, KS 66048-1958

Mailing address

605 Shawnee St
Leavenworth, KS 66048-1958
Phone (913) 680-0812

Other identifiers 8

IdentifierTypeStateIssuer
10811021OtherMOBCBS KANSAS CITY
CI9911OtherKSRR MEDICARE
10811021OtherPREFERRED HEALTH PROFESSI
C19910OtherKSRAILROAD MEDICARE
DC6685OtherMORR MEDICARE
004640OtherKSBCBS
CD7473OtherMORAILROAD MEDICARE
DC6685OtherMORAILROAD MEDICARE

Other names 1

  • Mid-America Anesthesia Care Former legal business name

National Provider Directory

National Provider Directory

Locations

605 Shawnee St
Leavenworth, KS 66048
Phone (913) 680-0812

11413 Ash St
Ste 100
Shawnee Mission, KS 66211
Phone (913) 661-9977

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1679555262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 SHAWNEE ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660481958",
            "telephone_number": "913-680-0812",
            "fax_number": "913-680-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 SHAWNEE ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660481958",
            "telephone_number": "913-680-0812",
            "fax_number": "913-680-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAVENWORTH ANESTHESIA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "COVILLO",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-680-0812",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KANSAS CITY",
            "identifier": "10811021",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CI9911",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH PROFESSI",
            "identifier": "10811021",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C19910",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DC6685",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "004640",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD7473",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC6685",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-America Anesthesia Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Leavenworth, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.