Individual provider Active NPI

Mary Ellen Colyer, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Peters, MO
National Provider Identifier
1932197480
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
047943 Issued in MO
Practice address
10 Hospital Dr
St Peters, MO 63376-1659
Phone
(314) 895-3828
Fax
(636) 922-5157
NPI assigned
Oct 10, 2005
Last updated
Mar 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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 047943 MO Primary

Addresses

Primary practice location

10 Hospital Dr
St Peters, MO 63376-1659

Mailing address

PO Box 5
Hazelwood, MO 63042-0005
Phone (314) 895-3828

Other identifiers 2

IdentifierTypeStateIssuer
430063799OtherMORAILROAD MEDICARE
919444109MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031105000160 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103738323 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Health Specialists LLCGroup PAC ID 9739494832, 69 clinicians
Eye Anesthesia LLCGroup PAC ID 5698922581, 10 clinicians

Practice addresses (Care Compare)

11525 Olde Cabin Rd
Suite 101
Creve Coeur, MO 63141-7146
Phone (314) 400-9999

12990 Manchester Rd
Suite 105
Saint Louis, MO 63131-1860
Phone 31468642004220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
047943MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Mar 15, 2018 Accepting new patients
Eye Anesthesia LLC CurrentSince Jun 1, 2022 Accepting new patients
Digestive Health Specialists, LLC CurrentSince Oct 1, 2023 Accepting new patients
Viking Anesthesia Services, LLC CurrentSince May 1, 2022 Accepting new patients

Locations

3800 S Whitney Ave
Ste 100
Independence, MO 64055

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

11525 Olde Cabin Rd
Ste 101
Saint Louis, MO 63141
Phone (314) 400-9999

12990 Manchester Rd
Ste 103
Saint Louis, MO 63131
Phone (314) 406-1408

12990 Manchester Rd
Ste 105
Saint Louis, MO 63131
Phone (314) 686-4200

633 Emerson Rd
Ste 140
Saint Louis, MO 63141
Phone (314) 991-2090

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1932197480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630420005",
            "telephone_number": "314-895-3828",
            "fax_number": "636-922-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HOSPITAL DR",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "633761659",
            "telephone_number": "314-895-3828",
            "fax_number": "636-922-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLYER",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "047943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430063799",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "919444109",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.