Individual provider Active NPI

Mary Jill Schaberg, CRNA

  • Certified Registered Nurse Anesthetist
  • Chesterfield, MO
National Provider Identifier
1831262187
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
056248 Issued in MO
Practice address
232 S Woods Mill Rd
Chesterfield, MO 63017
Phone
(314) 205-6917
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 056248 MO Primary

Addresses

Primary practice location

232 S Woods Mill Rd
Chesterfield, MO 63017

Mailing address

940 West Port Plaza
Ste 270
St Louis, MO 63146
Phone (314) 453-0600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100511000161 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416085568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
056248MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Anesthesia Care PC Nurse Anesthetist, Certified Registered CurrentSince May 22, 2002 Accepting new patients
Hannibal Anesthesia Associates LLC Past Accepting new patients

Locations

633 Emerson Rd
Ste 140
Saint Louis, MO 63141
Phone (314) 991-2090

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831262187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 WEST PORT PLAZA",
            "address_2": "STE 270",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63146",
            "telephone_number": "314-453-0600",
            "fax_number": "314-453-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 S WOODS MILL RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "314-205-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHABERG",
        "first_name": "MARY",
        "middle_name": "JILL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "056248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.