Individual provider Active NPI

Douglas A. Salerno, CRNA

  • Certified Registered Nurse Anesthetist
  • Shawnee Mission, KS
National Provider Identifier
1871579433
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
55041 Issued in KS
Practice address
9100 W 74TH St
Shawnee Mission, KS 66204-4004
Phone
(913) 676-2679
Fax
(913) 789-3191
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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 55041 KS Primary
Registered Nurse 163W00000X 81253 KS

Addresses

Primary practice location

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

Mailing address

9100 W 74TH St
Shawnee Mission, KS 66204-4004
Phone (913) 676-2679

Other identifiers 4

IdentifierTypeStateIssuer
100456090CMedicaidKS
P00708218OtherKSRR MEDICARE
100456090BMedicaidKS
919298000MedicaidMO

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
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
81253KSMDRegistered Nurse
55041KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Kansas City PA CurrentSince Dec 15, 2017 Accepting new patients
Kansas Pain Management Past Accepting new patients
Midwest Anesthesia Associates, PA Registered Nurse Past Accepting new patients

Locations

8717 W 110th St
Ste 600
Overland Park, KS 66210
Phone (913) 428-2910

10730 Nall Ave
Ste 100
Overland Park, KS 66211
Phone (913) 428-9000

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

6601 Rockhill Rd
Kansas City, MO 64131
Phone (816) 276-7000

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

Organizations & group practices 3

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1871579433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "SALERNO",
        "first_name": "DOUGLAS",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "55041",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "81253",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100456090C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00708218",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100456090B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "919298000",
            "state": "MO"
        }
    ],
    "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 Jul 31, 2013; 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.