Organization Active NPI

Westglen Endoscopy Center LLC

Doing business as Westglen Endoscopy Center

  • Certified Registered Nurse Anesthetist
  • Shawnee, KS
National Provider Identifier
1710215637
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
WESTGLEN ENDOSCOPY CENTER LLC
Doing business as
Westglen Endoscopy Center
Practice address
16663 Midland Dr
Suite 200
Shawnee, KS 66217-3042
Phone
(913) 248-8800
Fax
(913) 248-8858
NPI assigned
Dec 4, 2009
Last updated
Sep 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Authorized official

Name
Jeffrey Snodgrass
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

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

Addresses

Primary practice location

16663 Midland Dr
Suite 200
Shawnee, KS 66217-3042

Mailing address

16663 Midland Dr
Suite 200
Shawnee, KS 66217-3042
Phone (913) 248-8800

Other identifiers 6

IdentifierTypeStateIssuer
900404204OtherKSROBIN R. KROEGER CRNA
100318050CMedicaidKS
900404201OtherKSCRNA JAMES L. MATTINGLY
900404203OtherKSCRNA MARYELLEN WINTER
900404202OtherKSCRNA CHRISTIAN E. JACKSON
900404205OtherKSMARY SUNSHINE

Other names 1

  • Westglen Endoscopy Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050217000361 KS Part B Supplier - Ambulatory Surgical Center 2264484385 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shawnee, KS

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Westglen Endoscopy Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16663 Midland Dr
#200
Shawnee, KS 66217
Phone (913) 248-8800

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1710215637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16663 MIDLAND DR",
            "address_2": "SUITE 200",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662173042",
            "telephone_number": "913-248-8800",
            "fax_number": "913-248-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16663 MIDLAND DR",
            "address_2": "SUITE 200",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662173042",
            "telephone_number": "913-248-8800",
            "fax_number": "913-248-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTGLEN ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-04",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROBIN R. KROEGER CRNA",
            "identifier": "900404204",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100318050C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA JAMES L. MATTINGLY",
            "identifier": "900404201",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA MARYELLEN WINTER",
            "identifier": "900404203",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA CHRISTIAN E. JACKSON",
            "identifier": "900404202",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARY SUNSHINE",
            "identifier": "900404205",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westglen Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Westglen Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.