Individual provider Active NPI

Tia Anderson, CRNA

  • Certified Registered Nurse Anesthetist
  • Overland Park, KS
National Provider Identifier
1700310406
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2010025473 Issued in MO
Practice address
8717 W 110TH St
Suite 600
Overland Park, KS 66210-2144
Phone
(913) 428-2900
NPI assigned
Apr 19, 2017
Last updated
Jan 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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 43557509011 KS
Certified Registered Nurse Anesthetist 367500000X 2010025473 MO Primary

Addresses

Primary practice location

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

Mailing address

2401 Gillham Rd
Provider Enrollment
Kansas City, MO 64108-4619
Phone (816) 701-5200

Other practice location 1

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 234-3000

Other names 1

  • Tia Shomber Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170907000761 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587937909 Reassigns benefits to 2 organizations
I20221031000242 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587937909 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

11300 Corporate Ave
Suite 342
Lenexa, KS 66219-1368

3901 Rainbow Blvd
Kansas City, KS 66160-7415
Phone (913) 588-3315

3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone (913) 588-7013

4000 Cambridge St
Kansas City, KS 66160-8500

4000 Cambridge St
Suite G600
Kansas City, KS 66160-8501
Phone (913) 588-1227

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43557509011KSMDCertified Registered Nurse Anesthetist
2010025473MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Current Accepting new patients
Saint Luke's Physician Group Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 5, 2023 Accepting new patients
Anesthesia Associates of Kansas City PA CurrentSince Oct 1, 2022 Accepting new patients
Orthomed Staffing LLC CurrentSince Jul 18, 2023 Accepting new patients
Midwest Anesthesia Associates, PA Nurse Anesthetist, Certified Registered CurrentSince Dec 5, 2023 Accepting new patients
Kansas University Physicians Inc CurrentSince Mar 28, 2024 Accepting new patients
Kansas University Physicians Inc CurrentSince Mar 28, 2024 Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

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

11300 Corporate Ave
Ste 342
Lenexa, KS 66219
Phone (913) 574-0425

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

4940 W 137th St
Overland Park, KS 66224
Phone (913) 232-9846

7840 W 165th St
Overland Park, KS 66223
Phone (913) 236-6455

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

5721 W 119th St
Shawnee Msn, KS 66209
Phone (913) 253-3000

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

305 N Keene St
Ste 107
Columbia, MO 65201
Phone (573) 239-3310

200 NE 54th St
Unit 200
Kansas City, MO 64118

211 NE 54th St
Ste 100
Kansas City, MO 64118
Phone (816) 455-4214

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

901 E 104th St
Ste 400
Kansas City, MO 64131
Phone (816) 502-8752

2861 NE Independence Ave
Ste 101
Lees Summit, MO 64064
Phone (816) 579-1500

1040 Old des Peres Rd
Saint Louis, MO 63131
Phone (314) 729-9780

10435 Clayton Rd
Ste 110
Saint Louis, MO 63131
Phone (314) 576-1400

4594 S Lindbergh Blvd
Saint Louis, MO 63127
Phone (314) 842-2607

5139 Mattis Rd
Ste 100
Saint Louis, MO 63128
Phone (314) 729-9780

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Organizations & group practices 7

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 2

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1700310406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-701-5200",
            "fax_number": "816-302-9939"
        },
        {
            "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": [
        {
            "address_1": "2401 Gillham Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641084619",
            "country_code": "US",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "43557509011",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2010025473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIA",
            "last_name": "SHOMBER",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 21, 2019; 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.