Individual provider Active NPI

Brooke Kaderly

  • Anesthesiologist Assistant
  • Springfield, MO
National Provider Identifier
1780471813
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
1000 E Primrose St Ste 520
Springfield, MO 65807-7002
Phone
(417) 269-4550
NPI assigned
Apr 22, 2025
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

1000 E Primrose St Ste 520
Springfield, MO 65807-7002

Mailing address

925 Bainbridge Rd
Smithville, MO 64089-8754
Phone (816) 724-9510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250813000458 MO Practitioner - Anesthesiology Assistant 7517465024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozark Anesthesia Associates IncGroup PAC ID 1850290149, 86 clinicians

Practice addresses (Care Compare)

3801 S National Ave
Springfield, MO 65807-5210
Phone (417) 269-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Anesthesia Associates, Inc. CurrentSince Jul 22, 2025 Accepting new patients

Locations

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

1000 E Primrose St
Ste 520
Springfield, MO 65807
Phone (417) 269-4557

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 3

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": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1780471813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 BAINBRIDGE RD",
            "city": "SMITHVILLE",
            "state": "MO",
            "postal_code": "640898754",
            "telephone_number": "816-724-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PRIMROSE ST STE 520",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077002",
            "telephone_number": "417-269-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADERLY",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.