Individual provider Active NPI

Jennifer L Cronenwett, CRNA

  • Certified Registered Nurse Anesthetist
  • Joplin, MO
National Provider Identifier
1982650305
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2004000338 Issued in MO
Practice address
1531 E 32ND St Ste 6
Joplin, MO 64804-9810
Phone
(417) 627-9699
Fax
(417) 627-9602
NPI assigned
May 26, 2006
Last updated
Aug 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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 2004000338 MO Primary

Addresses

Primary practice location

1531 E 32ND St Ste 6
Joplin, MO 64804-9810

Mailing address

5404 Butterfield PL
Loma Linda, MO 64804-8870
Phone (417) 439-7448

Other identifiers 4

IdentifierTypeStateIssuer
200252340AMedicaidKS
P00112983OtherRR MEDICARE
200020780AMedicaidOK
919028001MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040429001172 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456348473 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joplin Ambulatory Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2009 Accepting new patients
Freeman Neosho Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Ambulatory Anesthesia Services of Missouri LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1531 E 32nd St
Ste 6
Joplin, MO 64804
Phone (417) 627-9699

1531 W 32nd St
Ste 107
Joplin, MO 64804
Phone (417) 781-3595

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, 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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1982650305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 BUTTERFIELD PL",
            "city": "LOMA LINDA",
            "state": "MO",
            "postal_code": "648048870",
            "telephone_number": "417-439-7448",
            "fax_number": "417-782-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 E 32ND ST STE 6",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648049810",
            "telephone_number": "417-627-9699",
            "fax_number": "417-627-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONENWETT",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2004000338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200252340A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00112983",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200020780A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "919028001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.