Individual provider Active NPI

Marguerite Elizabeth Kelly-Salo, CRNA

  • Certified Registered Nurse Anesthetist
  • Shawnee, KS
National Provider Identifier
1902047608
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
556879 Issued in KS
Practice address
14616 W 50TH St
Shawnee, KS 66216-5107
Phone
(913) 268-0284
NPI assigned
Mar 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1484333061 KS
Certified Registered Nurse Anesthetist 367500000X 556879 KS Primary

Addresses

Primary practice location

14616 W 50TH St
Shawnee, KS 66216-5107

Mailing address

14616 W 50TH St
Shawnee, KS 66216-5107
Phone (913) 268-0284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090625000112 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406907815 Reassigns benefits to 1 organization
I20230731000082 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406907815 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Four States Anesthesia Services LLCGroup PAC ID 8729973284, 32 clinicians

Practice addresses (Care Compare)

200 2ND Ave SW
Miami, OK 74354-6830
Phone (918) 540-7113

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1484333061KSMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Jul 17, 2023 Accepting new patients
Four States Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
Meritas Health Corporation Past Accepting new patients
Anesthesia Services of Omaha LLC Past Accepting new patients

Locations

200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

3001 Quail Springs Pkwy
Fl 5
Oklahoma City, OK 73134

Organizations & group practices 5

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": "1236643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244678400000",
    "number": "1902047608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14616 W 50TH ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662165107",
            "telephone_number": "913-268-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14616 W 50TH ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662165107",
            "telephone_number": "913-268-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY-SALO",
        "first_name": "MARGUERITE",
        "middle_name": "ELIZABETH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-10",
        "last_updated": "2009-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "1484333061",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "556879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.