Individual provider Active NPI

Edith A Payne, CRNA

  • Certified Registered Nurse Anesthetist
  • Lees Summit, MO
National Provider Identifier
1700986239
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
056282 Issued in MO
Practice address
250 NE Mulberry St Ste 202
SJS Medical Management
Lees Summit, MO 64086-4533
Phone
(816) 389-4130
Fax
(816) 389-4140
NPI assigned
Sep 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 056282 MO Primary

Addresses

Primary practice location

250 NE Mulberry St Ste 202
SJS Medical Management
Lees Summit, MO 64086-4533

Mailing address

250 NE Mulberry St Ste 202
SJS Medical Management
Lees Summit, MO 64086-4533
Phone (816) 389-4130

Other identifiers 1

IdentifierTypeStateIssuer
912919768MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Services of Blue Springs Past Accepting new patients
Anesthesia Services of Eastern Jackson County, P.C. Past Accepting new patients
Consultants in Gastroenterology, PC PastSince Jul 11, 2011 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1700986239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 NE MULBERRY ST STE 202",
            "address_2": "SJS MEDICAL MANAGEMENT",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640864533",
            "telephone_number": "816-389-4130",
            "fax_number": "816-389-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NE MULBERRY ST STE 202",
            "address_2": "SJS MEDICAL MANAGEMENT",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640864533",
            "telephone_number": "816-389-4130",
            "fax_number": "816-389-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "EDITH",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "056282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "912919768",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.