Individual provider Active NPI

Kimberly A Clyne, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
National Provider Identifier
1770989170
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2015003185 Issued in MO
Practice address
1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003
Phone
(314) 362-6973
Fax
(314) 362-1185
NPI assigned
Nov 12, 2014
Last updated
Oct 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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 2015003185 MO Primary

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003

Mailing address

660 S Euclid Ave
C B 8054
Saint Louis, MO 63110-1010
Phone (314) 362-6973

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150408001377 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466770235 Reassigns benefits to 8 organizations

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
Eye Anesthesia LLCGroup PAC ID 5698922581, 10 clinicians

Practice addresses (Care Compare)

12990 Manchester Rd
Suite 105
Saint Louis, MO 63131-1860
Phone 31468642004220

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Anesthesia Care PC Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2020 Accepting new patients
Premier Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 7, 2022 Accepting new patients
SW Anesthesia LLC CurrentSince May 27, 2023 Accepting new patients
Gateway Anesthesia Group LLC CurrentSince Sep 2, 2023 Accepting new patients
Washington University CurrentSince Feb 22, 2015 Accepting new patients
Eye Anesthesia LLC CurrentSince Oct 1, 2020 Accepting new patients
Specialists in Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2023 Accepting new patients
Washington University CurrentSince Feb 22, 2015 Accepting new patients

Locations

14825 North Outer 40 Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 898-4695

17300 North Outer 40 Rd
Ste 100
Chesterfield, MO 63005
Phone (314) 865-7992

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

1 Barnes Jewish Hospital Plz
#P
Saint Louis, MO 63110
Phone (618) 474-1074

10296 Big Bend Rd
Saint Louis, MO 63122
Phone (314) 543-5970

12345 W Bend Dr
Ste 201
Saint Louis, MO 63128
Phone (314) 722-2530

12990 Manchester Rd
Ste 103
Saint Louis, MO 63131
Phone (314) 406-1408

12990 Manchester Rd
Ste 105
Saint Louis, MO 63131
Phone (314) 686-4200

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

660 S Euclid Ave
#C
Saint Louis, MO 63110

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

16 Chamber Dr
Washington, MO 63090
Phone (636) 239-9122

901 Patients First Dr
#108
Washington, MO 63090
Phone (636) 390-1715

Interoperability endpoints

  • Direct secure messaging: kclyne741397@directc.mercy.net

Organizations & group practices 8

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": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1770989170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "C B 8054",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-6973",
            "fax_number": "314-362-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-6973",
            "fax_number": "314-362-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYNE",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2015003185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.