Individual provider Active NPI

Corry Alan Coopmans, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
National Provider Identifier
1952568313
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
124635 Issued in MO
Practice address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone
(314) 251-6064
NPI assigned
May 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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 124635 MO Primary

Addresses

Primary practice location

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Mailing address

17873 Suzanne Ridge Dr
Wildwood, MO 63038-1474
Phone (636) 821-1999

Other practice location 1

1101 W Liberty St
Farmington, MO 63640-1921
Phone (573) 760-8002

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090211000399 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941365761 Reassigns benefits to 8 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
Acuity Anesthesiology LLCGroup PAC ID 6305992652, 22 clinicians

Practice addresses (Care Compare)

1400 US Hwy 61
Festus, MO 63028-4100
Phone (636) 933-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124635MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CPR Anesthesia, Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
Aim Anesthesia LLC CurrentSince Jul 1, 2021 Accepting new patients
Dreamland Uap Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 6, 2021 Accepting new patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Sep 2, 2021 Accepting new patients
Acuity Anesthesiology LLC CurrentSince Dec 1, 2024 Accepting new patients
Commonwealth Anesthesia Associates, P.C. Past Accepting new patients

Locations

865406 Reliable Pkwy
Chicago, IL 60686

3550 McKelvey Rd
Bridgeton, MO 63044
Phone 31474109114048

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

1101 W Liberty St
Farmington, MO 63640
Phone (573) 705-1272

400 Parkland Dr
Farmington, MO 63640
Phone (303) 755-3201

100 Village Sq
Hazelwood, MO 63042
Phone (314) 355-4010

Organizations & group practices 8

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 1

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1952568313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17873 SUZANNE RIDGE DR",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630381474",
            "telephone_number": "636-821-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 W Liberty St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636401921",
            "country_code": "US",
            "telephone_number": "573-760-8002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPMANS",
        "first_name": "CORRY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "124635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1101 W Liberty St",
            "city": "Farmington",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636401921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.