Mid-Land Anesthesia Associates

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

MID-LAND ANESTHESIA ASSOCIATES

Practice address

219 Physicians Park
Poplar Bluff, MO 63901-3956

Phone

(573) 686-5550

NPI assigned

Jan 12, 2006

Organization subpart

No

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

Authorized official

Name

Patrick Roberts, CPA

Title

President

Phone

(573) 686-5550

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1699754242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 366",
            "city": "WILLIAMSVILLE",
            "state": "MO",
            "postal_code": "639679724",
            "telephone_number": "573-686-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 PHYSICIANS PARK",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013956",
            "telephone_number": "573-686-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-LAND ANESTHESIA ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-686-5550",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA7268",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO BCBS",
            "identifier": "184883",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannan Meyer, LPN
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• Certified Registered Nurse Anesthetist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.