Individual provider Active NPI

Amanda Eileen Cooney

  • Certified Registered Nurse Anesthetist
  • Des Moines, IA
National Provider Identifier
1831465459
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D119983 Issued in IA
Practice address
700 E University Ave
Des Moines, IA 50316-2302
Phone
(515) 263-5833
NPI assigned
Mar 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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 D119983 IA Primary

Addresses

Primary practice location

700 E University Ave
Des Moines, IA 50316-2302

Mailing address

1760 NW 32ND LN Unit 32
Ankeny, IA 50023-7750
Phone (402) 658-1535

Other names 1

  • Amanda Eileen Wyatt Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141006002430 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961622303 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D119983IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center-Newton CurrentSince Jun 1, 2021 Accepting new patients
Mercy Medical Center-Newton Nurse Anesthetist, Certified Registered Current Accepting new patients
Mercy Medical Center-Newton CurrentSince Jun 1, 2021 Accepting new patients

Locations

204 N 4th Ave E
Newton, IA 50208
Phone (641) 791-4800

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical Center-Newton 15 clinicians

Practice addresses (Care Compare)

204 N 4TH Ave E
Newton, IA 50208-3135
Phone (641) 792-1273

Hospital & facility affiliations

  • Mercyone Newton Medical Center Hospital, Newton, IA, CCN 160032

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1831465459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 NW 32ND LN UNIT 32",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500237750",
            "telephone_number": "402-658-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162302",
            "telephone_number": "515-263-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COONEY",
        "first_name": "AMANDA",
        "middle_name": "EILEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D119983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WYATT",
            "middle_name": "EILEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.

Verify at the official NPI Registry.