Individual provider Active NPI

Regina L Viviano, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
National Provider Identifier
1821362500
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2013032668 Issued in MO
Practice address
12634 Olive Blvd
Dept Anesthesiology
Saint Louis, MO 63141-6337
Phone
(800) 862-9980
Fax
(314) 362-1185
NPI assigned
Feb 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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 2013032668 MO Primary

Addresses

Primary practice location

12634 Olive Blvd
Dept Anesthesiology
Saint Louis, MO 63141-6337

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (800) 862-9980

Other identifiers 1

IdentifierTypeStateIssuer
910155979MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140328001698 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466611868 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013032668MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2026 Accepting new patients
Orthomed Staffing LLC CurrentSince Jan 1, 2026 Accepting new patients
Memorial Medical Center CurrentSince Mar 5, 2012 Accepting new patients
Memorial Medical Center Nurse Anesthetist, Certified Registered CurrentSince Mar 5, 2012 Accepting new patients

Locations

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

17050 Baxter Rd
Ste 110
Chesterfield, MO 63005
Phone (636) 537-0122

305 N Keene St
Ste 107
Columbia, MO 65201
Phone (573) 239-3310

211 NE 54th St
Ste 100
Kansas City, MO 64118
Phone (816) 455-4214

12639 Old Tesson Rd
Ste 130
Saint Louis, MO 63128
Phone (314) 729-0785

1050 Old des Peres Rd
Ste 150
Saint Louis, MO 63131
Phone (314) 396-9517

5139 Mattis Rd
Ste 100
Saint Louis, MO 63128
Phone (314) 207-8939

4594 S Lindbergh Blvd
Saint Louis, MO 63127
Phone (314) 842-2607

9701 Landmark Parkway Dr
Ste 100
Saint Louis, MO 63127
Phone (314) 396-9517

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

100 Entrance Way
Saint Peters, MO 63376
Phone (363) 916-7140

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1821362500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12634 OLIVE BLVD",
            "address_2": "DEPT ANESTHESIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416337",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVIANO",
        "first_name": "REGINA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-28",
        "last_updated": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2013032668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910155979",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "12634 Olive Blvd",
            "address_2": "Dept Anesthesiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.