Kevin Luke Kanallakan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2018029592 Issued in MO

Practice address

6420 Clayton Rd
Richmond Heights, MO 63117-1811

Phone

(314) 768-8000

NPI assigned

Aug 14, 2018

Last updated

Aug 14, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

G and G Anesthesia LLCGroup PAC ID 4981912607, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Anthony's Health Center Hospital, Alton, IL, CCN 140052

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• G & G Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Maryville, IL
  • NPI 1487020111

  MO, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Osf Healthcare System

  dba Osf Saint Anthony's Health Center

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1710396932
  Care Compare affiliation

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1710466305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 DEPOT DR",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620342755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANALLAKAN",
        "first_name": "KEVIN",
        "middle_name": "LUKE",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2018029592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Haydon Therapy, LLC
• Erin Ruth Jones, RRT
• Mieashia Jones
• Jaicy Joseph
• Janae Kadlec, OD
• Haruka Kawata, MA, LPC, ATR
• Cynthia M Kempf, MA, OTR/L
• Tina Kern, RN
• Ayooluwa Kerrigan, DO
• Lisa Kim

• Certified Registered Nurse Anesthetist in Richmond Heights, MO
• Providers in Richmond Heights, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.