Kelli Elise Heacock, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Shawnee Mission, KS
NPI 1962267211 · NPPES record last updated Jun 18, 2025
Key facts
- NPI
- 1962267211
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 558290 (KS)
- Practice address
- 9100 W 74TH St
Shawnee Mission, KS 66204-4004 - Phone
- (913) 632-2230
- Fax
- (913) 632-2297
- NPI assigned
- Feb 15, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Midwest Anesthesia Associates, PA
Practice addresses (Care Compare)
9100 W 14TH St
Shawnee Mission, KS 66204-4004
Phone (913) 632-2230
Hospital & facility affiliations
- Adventhealth Shawnee Mission
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250718002200 | KS | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9032625801 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 558290 | KS | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Anesthesia Associates, PA | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
Locations
9301 W 74th St
Ste 300
Shawnee Msn, KS 66204
Phone (913) 632-9300
9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Certified Registered Nurse Anesthetist | 367500000X | 558290 | KS | Yes |
Addresses
Primary practice location
9100 W 74TH St
Shawnee Mission, KS 66204-4004
Mailing address
2301 Holmes St
Kansas City, MO 64108-2640
Other practice location 1
2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-1127
Other names
- Kelli Elise Reinkemeyer
Other providers in Shawnee Mission, KS
- Sarah-Grace Miller Hamm
- Samantha Hance
- Erin Haniger
- Andrew Harmon
- Lisa Harris
- Health Partnership Clinic, Inc
- Healthy Life Chiropractic LLC
- Hearing Associates Inc
- Heart of America Eye Care, PA
- Sarah A Heath
All providers in Shawnee Mission, KS · Certified Registered Nurse Anesthetist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.