Individual provider Active NPI

Angela H Sperry

  • Certified Registered Nurse Anesthetist
  • Shawnee Mission, KS
National Provider Identifier
1740525492
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
557468 Issued in KS
Practice address
9100 W 74TH St
Shawnee Mission, KS 66204-4004
Phone
(913) 632-2230
Fax
(913) 632-2297
NPI assigned
Dec 6, 2012
Last updated
Nov 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2017010131 MO
Certified Registered Nurse Anesthetist 367500000X RN2282545 MA
Certified Registered Nurse Anesthetist 367500000X 397034 OH
Certified Registered Nurse Anesthetist 367500000X 557468 KS Primary
Registered Nurse 163W00000X 139085 KS
Registered Nurse 163W00000X 2017002769 MO

Addresses

Primary practice location

9100 W 74TH St
Shawnee Mission, KS 66204-4004

Mailing address

PO Box 411895
Kansas City, MO 64141-1895
Phone (913) 632-2230

Other practice location 1

100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone (816) 347-5097

Other identifiers 5

IdentifierTypeStateIssuer
P02116101OtherMORAILROAD
57876042OtherMOBCBS KC
201122090AMedicaidKS
910051443MedicaidMO
57876022OtherKSBCBS KC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180227002799 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234375403 Reassigns benefits to 2 organizations
I20180613002065 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234375403 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Georgetown University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes East Anesthesia Services PCGroup PAC ID 1850333477, 44 clinicians
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone (816) 347-5097

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
139085KSMDRegistered Nurse
2017002769MOMDRegistered Nurse
RN2282545MAMDCertified Registered Nurse Anesthetist
2017010131MOMDCertified Registered Nurse Anesthetist
397034OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Lukes Physician Group Inc CurrentSince Jan 3, 2023 Accepting new patients
Saint Luke's Physician Group Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 3, 2023 Accepting new patients
Outpatient Anesthesia Specialists LLC Nurse Anesthetist, Certified Registered CurrentSince May 16, 2018 Accepting new patients
Midwest Anesthesia Associates, PA Registered Nurse CurrentSince Jun 3, 2018 Accepting new patients
St Lukes East Anesthesia Services,P.C. CurrentSince May 21, 2018 Accepting new patients

Locations

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

9301 W 74th St
Ste 300
Shawnee Msn, KS 66204
Phone (913) 632-9300

1800 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 523-0100

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

100 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5097

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Organizations & group practices 5

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 4

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": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1740525492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411895",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641411895",
            "telephone_number": "913-632-2230",
            "fax_number": "913-632-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-632-2230",
            "fax_number": "913-632-2297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 NE Saint Lukes Blvd",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640866000",
            "country_code": "US",
            "telephone_number": "816-347-5097",
            "fax_number": "816-347-5045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPERRY",
        "first_name": "ANGELA",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-06",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2017010131",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2282545",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "397034",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "557468",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "139085",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2017002769",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P02116101",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "57876042",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201122090A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910051443",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "57876022",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee Mission, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.