Active NPI
Leslie Ray Waltman III, CRNA
- Certified Registered Nurse Anesthetist
- Overland Park, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2012006261
- Practice address
- 8717 W 110TH St
Suite 600
Overland Park, KS 66210-2144 - Phone
- (205) 474-3208
- NPI assigned
- Dec 8, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1-115596 | AL | |
| Certified Registered Nurse Anesthetist | 367500000X | 2012006261 | MO | Primary |
| Registered Nurse | 163W00000X | 2011040586 | MO |
Addresses
Primary practice location
8717 W 110TH St
Suite 600
Overland Park, KS 66210-2144
Mailing address
1308 E Briggs Dr
Macon, MO 63552-1919
Phone (660) 415-5215
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- University of Alabama School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
54 Hospital Dr
Osage Beach, MO 65065-3050
Phone (573) 348-8000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-115596 | AL | MD | Registered Nurse |
| 2011040586 | MO | MD | Registered Nurse |
| 2012006261 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Ozark Anesthesia & Associates, Inc | Current | Accepting new patients | |
| Lake of the Ozarks Pain Management Services, Inc | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772
Organizations & group practices 2
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.
-
- Specialist
- Osage Beach, MO
- NPI 1184719049
-
- Specialist
- Osage Beach, MO
- NPI 1003901976
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Osage Beach, MO
- NPI 1386619450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518998400000",
"number": "1790053569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1308 E BRIGGS DR",
"city": "MACON",
"state": "MO",
"postal_code": "635521919",
"telephone_number": "660-415-5215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8717 W 110TH ST",
"address_2": "SUITE 600",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662102144",
"telephone_number": "205-474-3208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTMAN",
"first_name": "LESLIE",
"middle_name": "RAY",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-08",
"last_updated": "2018-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AL",
"license": "1-115596",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2012006261",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2011040586",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; 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.