NPIMap

Individual provider Active NPI

Jeevan Bhatta, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Leonard Wood, MO
National Provider Identifier
1861844003
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2024020912 Issued in MO
Practice address
4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098
Phone
(573) 596-0417
NPI assigned
Jul 12, 2016
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 1-121107 AL
Certified Registered Nurse Anesthetist 367500000X 2024020912 MO Primary

Addresses

Primary practice location

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098

Mailing address

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098
Phone (573) 596-0417

Other practice location 1

1100 N Kentucky Ave
West Plains, MO 65775-2029
Phone (417) 256-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241221000054 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840675625 Reassigns benefits to 4 organizations
I20260406000223 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840675625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozarks Medical CenterGroup PAC ID 3870491863, 166 clinicians
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians
Emerald Valley AnesthesiaGroup PAC ID 8729437199, 8 clinicians
Ozark Anesthesia Associates IncGroup PAC ID 1850290149, 86 clinicians

Practice addresses (Care Compare)

1100 N Kentucky Ave
Ozarks Healthcare General Surgery
West Plains, MO 65775-2029
Phone (417) 257-6782

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

360 S Garden Way
Suite 290
Eugene, OR 97401-8175
Phone (541) 844-1807

3801 S National Ave
Springfield, MO 65807-5210
Phone (417) 269-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-121107ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jun 2, 2025 Accepting new patients
Ozarks Medical Center CurrentSince Nov 1, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jun 2, 2025 Accepting new patients
Ozark Anesthesia Associates, Inc. CurrentSince Dec 6, 2024 Accepting new patients
Ozarks Medical Center CurrentSince Nov 1, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jun 2, 2025 Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1000 E Primrose St
Ste 520
Springfield, MO 65807
Phone (417) 269-4557

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959

Organizations & group practices 7

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1861844003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-0417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N Kentucky Ave",
            "address_purpose": "LOCATION",
            "city": "West Plains",
            "state": "MO",
            "postal_code": "657752029",
            "country_code": "US",
            "telephone_number": "417-256-9111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHATTA",
        "first_name": "JEEVAN",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-12",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-121107",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2024020912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leonard Wood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.