Individual provider Active NPI

Kori A Stechmesser, CRNA

  • Certified Registered Nurse Anesthetist
  • Fenton, MO
National Provider Identifier
1891037685
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2004017929 Issued in MO
Practice address
1015 Bowles Ave
Fenton, MO 63026-2394
Phone
(314) 775-2816
NPI assigned
Mar 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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 2004017929 MO Primary

Addresses

Primary practice location

1015 Bowles Ave
Fenton, MO 63026-2394

Mailing address

13515 Barrett Parkway Dr
Ste 170
Ballwin, MO 63021-5870
Phone (314) 775-2816

Other names 1

  • Kori A Johnson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130802000393 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476794421 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-West Anesthesia Partners LLCGroup PAC ID 1557842911, 42 clinicians
Metro-West Anesthesia Group IncGroup PAC ID 2163329921, 204 clinicians
Missouri Baptist Medical CenterGroup PAC ID 3476461955, 123 clinicians

Practice addresses (Care Compare)

1130 Town and Country Commons Dr
Town and Country, MO 63017-8200
Phone (636) 256-0320

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone (314) 453-0600

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000

Hospital & facility affiliations

  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
  • SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2004017929MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro-West Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince May 18, 2013 Accepting new patients
Missouri Baptist Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jun 21, 2024 Accepting new patients

Locations

13515 Barrett Parkway Dr
Ste 170
Ballwin, MO 63021
Phone (314) 775-2811

400 S Woods Mill Rd
Ste 140
Chesterfield, MO 63017
Phone (314) 485-1101

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1891037685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13515 BARRETT PARKWAY DR",
            "address_2": "STE 170",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630215870",
            "telephone_number": "314-775-2816",
            "fax_number": "314-775-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 BOWLES AVE",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262394",
            "telephone_number": "314-775-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STECHMESSER",
        "first_name": "KORI",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2004017929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KORI",
            "last_name": "JOHNSON",
            "middle_name": "A",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.