Individual provider Active NPI

Koko Camita Cantrell, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Carson, CO
National Provider Identifier
1740250059
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
125811 Issued in CO
Practice address
USA Meddac. Evans Army Community Hospital
Anesthesia Dept
Fort Carson, CO 80913-4604
Phone
(719) 526-7944
NPI assigned
Jan 26, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 125811 CO Primary

Addresses

Primary practice location

USA Meddac. Evans Army Community Hospital
Anesthesia Dept
Fort Carson, CO 80913-4604

Mailing address

250 Thames Dr
Colorado Springs, CO 80906-5951
Phone (719) 520-0874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141013000307 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082768684 Reassigns benefits to 1 organization
I20210304000511 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082768684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates Northwest LLCGroup PAC ID 7618908484, 80 clinicians

Practice addresses (Care Compare)

74 B Centennial Loop
Suite 100
Eugene, OR 97401-7919
Phone (541) 780-6654

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125811COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CPR Anesthesia, Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2015 Accepting new patients
Anesthesia Associates Northwest LLC CurrentSince Feb 16, 2021 Accepting new patients
Novamed Surgery Center of Denver LLC Past Accepting new patients
Novamed Surgery Center of Colorado Springs, LLC Past Accepting new patients

Locations

715 N Weber St
Ste 100
Colorado Springs, CO 80903
Phone (719) 473-6115

401 Kendall Dr
Lamar, CO 81052
Phone (719) 336-4343

74B Centennial Loop
Ste 100
Eugene, OR 97401
Phone (541) 686-3791

120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883

2435 NW Kline St
Roseburg, OR 97471
Phone (541) 672-2020

1330 Commercial St SE
Salem, OR 97302
Phone (503) 763-1973

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1740250059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 THAMES DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809065951",
            "telephone_number": "719-520-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA MEDDAC. EVANS ARMY COMMUNITY HOSPITAL",
            "address_2": "ANESTHESIA DEPT",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "KOKO",
        "middle_name": "CAMITA",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "125811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.