Individual provider Active NPI

Joseph M. Faries, CRNA

  • Certified Registered Nurse Anesthetist
  • Jefferson City, MO
National Provider Identifier
1679562003
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
146558 Issued in MO
Practice address
1445 Christy Dr
Jefferson City, MO 65101-2853
Phone
(573) 636-3483
Fax
(573) 636-5315
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 146558 MO Primary

Addresses

Primary practice location

1445 Christy Dr
Jefferson City, MO 65101-2853

Mailing address

525 Couch Ave
St. Joe Hospital of Kirkwood
Kirkwood, MO 63122-5536
Phone (573) 636-3483

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040816000003 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012980451 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ste Genevieve County Memorial HospitalGroup PAC ID 3274432802, 74 clinicians

Practice addresses (Care Compare)

800 Genevieve Dr
Ste Genevieve, MO 63670-1434
Phone (573) 883-2751

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
146558MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Aug 30, 2021 Accepting new patients
Mercy Hospital Jefferson Past Accepting new patients
Mid-Missouri Anesthesia Consultants PC PastSince Jul 1, 1996 Accepting new patients
Advanced Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1101 W Liberty St
Farmington, MO 63640
Phone (573) 705-1272

400 Parkland Dr
Farmington, MO 63640
Phone (303) 755-3201

1101 W Liberty St
#97
Farmington, MO 63640

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

Organizations & group practices 5

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679562003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 COUCH AVE",
            "address_2": "ST. JOE HOSPITAL OF KIRKWOOD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225536",
            "telephone_number": "573-636-3483",
            "fax_number": "573-636-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 CHRISTY DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651012853",
            "telephone_number": "573-636-3483",
            "fax_number": "573-636-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIES",
        "first_name": "JOSEPH",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "146558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.