Pro Anesthesia LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

PRO ANESTHESIA LLC

Practice address

1008 N Main St
Sikeston, MO 63801-5044

Phone

(888) 447-7220

Fax

(336) 884-1643

NPI assigned

Nov 15, 2006

Last updated

Jun 21, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth CHI-Kong Moy, DO

Title

Owner

Phone

(800) 277-8151

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1699847558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638010220",
            "telephone_number": "888-447-7220",
            "fax_number": "336-884-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "888-447-7220",
            "fax_number": "336-884-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "MOY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "CHI-KONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-277-8151",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "125876",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.