Individual provider Active NPI

Jacqueline R Morrison, CRNA

  • Certified Registered Nurse Anesthetist
  • Shawnee Mission, KS
National Provider Identifier
1790865442
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
54253 Issued in KS
Practice address
9100 W 74TH St
Shawnee Mission, KS 66204-4004
Phone
(913) 676-2679
Fax
(913) 789-3191
NPI assigned
Oct 17, 2006
Last updated
Feb 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 54253 KS Primary
Registered Nurse 163W00000X 1345478092 KS

Addresses

Primary practice location

9100 W 74TH St
Shawnee Mission, KS 66204-4004

Mailing address

PO Box 411895
Dept. 109
Kansas City, MO 64141-1895
Phone (913) 676-2679

Other identifiers 3

IdentifierTypeStateIssuer
100326290BMedicaidKS
1790865442MedicaidMO
430020174OtherKSRR MEDICARE

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

State licenses

LicenseStateTypeSpecialty
1345478092KSMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Guardian Anesthesia Services Nurse Anesthetist, Certified Registered Past Accepting new patients
Leavenworth Anesthesia PA Nurse Anesthetist, Certified Registered Past Accepting new patients

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, 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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1790865442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411895",
            "address_2": "DEPT. 109",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641411895",
            "telephone_number": "913-676-2679",
            "fax_number": "913-789-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2679",
            "fax_number": "913-789-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "JACQUELINE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "54253",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "1345478092",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100326290B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790865442",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "430020174",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee Mission, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.