Individual provider Active NPI

Mary McDonough Schiller, CRNA

  • Certified Registered Nurse Anesthetist
  • Chesterfield, MO
National Provider Identifier
1730504119
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2001016540 Issued in MO
Practice address
400 S Woods Mill Rd Ste 140
Chesterfield, MO 63017-3427
Phone
(314) 485-1104
Fax
(314) 485-1104
NPI assigned
Feb 21, 2014
Last updated
Feb 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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 2001016540 MO Primary

Addresses

Primary practice location

400 S Woods Mill Rd Ste 140
Chesterfield, MO 63017-3427

Mailing address

400 S Woods Mill Rd Ste 140
Chesterfield, MO 63017-3427
Phone (314) 485-1101

Other names 1

  • Mary M McDonough-Smith Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140529001163 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810110491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro-West Anesthesia Group IncGroup PAC ID 2163329921, 204 clinicians

Practice addresses (Care Compare)

300 1St Capitol Dr
Saint Charles, MO 63301-2844
Phone (636) 947-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2001016540MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro-West Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 16, 2015 Accepting new patients

Locations

400 S Woods Mill Rd
Ste 140
Chesterfield, MO 63017
Phone (314) 485-1101

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

Organizations & group practices 1

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 1

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": "1392940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1730504119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S WOODS MILL RD STE 140",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173427",
            "telephone_number": "314-485-1101",
            "fax_number": "314-485-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S WOODS MILL RD STE 140",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173427",
            "telephone_number": "314-485-1104",
            "fax_number": "314-485-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH SCHILLER",
        "first_name": "MARY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-21",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2001016540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MCDONOUGH-SMITH",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.