John R Driver, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Cape Fair, MO
NPI 1790770451 · NPPES record last updated Oct 3, 2024
Key facts
- NPI
- 1790770451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 058819 (MO)
- Practice address
- 806 Lakehome LN
Cape Fair, MO 65624-5305 - Phone
- (417) 669-9382
- NPI assigned
- Sep 19, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Associates of Kansas City PA | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 058819 | MO | Yes |
Addresses
Primary practice location
806 Lakehome LN
Cape Fair, MO 65624-5305
Mailing address
806 Lakehome LN
Cape Fair, MO 65624-5305
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 194111 | Other | MO | BCBS |
| 912834686 | Medicaid | MO | |
| 22941 | Other | MO | COX HEALTH |
| 158514001 | Medicaid | AR | |
| 210165 | Other | MO | HEALTHLINK |
| 912834611 | Medicaid | MO | |
| P00217677 | Other | MO | RAILROAD |
| 200089370A | Medicaid | OK | |
| 20174319965616B008 | Other | MO | TRICARE |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.