Individual provider Active NPI

Laura Stallbaumer Donnelly, CRNA

  • Certified Registered Nurse Anesthetist
  • Overland Park, KS
National Provider Identifier
1700143328
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
43557080072 Issued in KS
Practice address
8717 W 110TH St
Suite 600
Overland Park, KS 66210-2144
Phone
(913) 428-2900
NPI assigned
Apr 19, 2012
Last updated
Oct 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 43557080072 KS Primary
Registered Nurse 163W00000X 14100436072 KS
Registered Nurse 163W00000X 2009010446 MO

Addresses

Primary practice location

8717 W 110TH St
Suite 600
Overland Park, KS 66210-2144

Mailing address

6715 W 156TH Ter
Overland Park, KS 66223-3597
Phone (913) 523-4561

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121110000015 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749431278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
76.07
Promoting interoperability
100
Improvement activities
40
Cost
65.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14100436072KSMDRegistered Nurse
2009010446MOMDRegistered Nurse
43557080072KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke's Physician Group Inc Nurse Anesthetist, Certified Registered CurrentSince May 8, 2023 Accepting new patients
Anesthesia Associates of Kansas City PA CurrentSince Jul 9, 2012 Accepting new patients

Locations

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

10730 Nall Ave
Ste 100
Overland Park, KS 66211
Phone (913) 428-9000

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

8717 W 110th St
Ste 600
Overland Park, KS 66210
Phone (913) 428-2910

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

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 4

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": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1700143328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 W 156TH TER",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233597",
            "telephone_number": "913-523-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8717 W 110TH ST",
            "address_2": "SUITE 600",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102144",
            "telephone_number": "913-428-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "LAURA",
        "middle_name": "STALLBAUMER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "43557080072",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "14100436072",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2009010446",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.