Individual provider Active NPI

William Kendrick Spalding, CRNA

  • Certified Registered Nurse Anesthetist
  • Cameron, MO
National Provider Identifier
1770561680
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
031915 Issued in MO
Practice address
1600 E Evergreen St
Cameron, MO 64429-2400
Phone
(816) 649-3348
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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 031915 MO Primary

Addresses

Primary practice location

1600 E Evergreen St
Cameron, MO 64429-2400

Mailing address

1600 E Evergreen St
PO Box 557
Cameron, MO 64429-2400
Phone (816) 632-2101

Other identifiers 3

IdentifierTypeStateIssuer
P0038238OtherMOMEDICARE RAILROAD
18085078OtherMOBCBSKC PROVIDER NUMBER
918061607MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031915MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamos Anesthesia Services LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Consultants in Gastroenterology, PC PastSince Jul 11, 2011 Accepting new patients
Leavenworth Anesthesia PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia & Pain Management Nurse Anesthetist, Certified Registered Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1770561680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E EVERGREEN ST",
            "address_2": "PO BOX 557",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "644292400",
            "telephone_number": "816-632-2101",
            "fax_number": "816-649-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E EVERGREEN ST",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "644292400",
            "telephone_number": "816-649-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPALDING",
        "first_name": "WILLIAM",
        "middle_name": "KENDRICK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "031915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P0038238",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC PROVIDER NUMBER",
            "identifier": "18085078",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "918061607",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.