Mark Panther, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

059546 Issued in IA

Practice address

5445 Avenue O
Fort Madison, IA 52627-9611

Phone

(319) 372-6530

NPI assigned

Mar 9, 2006

Last updated

Apr 29, 2008By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Midwest Anesthesia Care Inc

  dba Midwest Anesthesia Care LTD

  • Certified Registered Nurse Anesthetist
  • Fort Madison, IA
  • NPI 1568430825
  Authorized official Same address or phone

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1730157223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 10TH ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 AVENUE O",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526279611",
            "telephone_number": "319-372-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTHER",
        "first_name": "MARK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "059546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1190207",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IA",
            "identifier": "49303",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casandra Nickel
• Jennifer O'Day-Dostalek, PHARM.D.
• Paul Francis Ostby, P.A.-C.
• Linda D. Owen
• Meenakshi Devi Palani, D.O.
• Larry Don Peck, OD
• Heather Leigh Perry, DPM
• Trevor Pezley, ATC, LAT
• Planned Parenthood of the Heartland
• Kelsey Ann Price, R.D., L.D.

• Certified Registered Nurse Anesthetist in Fort Madison, IA
• Providers in Fort Madison, IA by specialty
• Certified Registered Nurse Anesthetist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.