Individual provider Active NPI

Charles Edwin Barry

  • Certified Registered Nurse Anesthetist
  • Cherokee, IA
National Provider Identifier
1689949356
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D129223 Issued in IA
Practice address
300 Sioux Valley Dr
Cherokee, IA 51012-1205
Phone
(712) 225-5101
NPI assigned
Mar 14, 2012
Last updated
Apr 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X D129223 IA Primary
Student in an Organized Health Care Education/Training Program 390200000X 129223 IA

Addresses

Primary practice location

300 Sioux Valley Dr
Cherokee, IA 51012-1205

Mailing address

1125 W Willow St
Cherokee, IA 51012-1564
Phone (319) 541-6501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140908002164 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042439960 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakes Regional HealthcareGroup PAC ID 0941118442, 37 clinicians

Practice addresses (Care Compare)

2301 Hwy 71
Spirit Lake, IA 51360-1184

2301 Hwy 71
Spirit Lake, IA 51360-1253
Phone (712) 336-1230

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D129223IAMDCertified Registered Nurse Anesthetist
129223IAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Lakes Regional Healthcare Current Accepting new patients
Northwest Iowa Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Jan 3, 2017 Accepting new patients

Locations

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

2301 Highway 71
Spirit Lake, IA 51360
Phone (712) 336-3750

400 10th St E
Waconia, MN 55387

Organizations & group practices 2

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 1

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": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1689949356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 W WILLOW ST",
            "city": "CHEROKEE",
            "state": "IA",
            "postal_code": "510121564",
            "telephone_number": "319-541-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SIOUX VALLEY DR",
            "city": "CHEROKEE",
            "state": "IA",
            "postal_code": "510121205",
            "telephone_number": "712-225-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY",
        "first_name": "CHARLES",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-14",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D129223",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "129223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.