| John M Ricketts, CRNA | |
|
1231 1st St, Kennett, MO 63857-2527 | |
| (573) 888-4522 | |
| Not Available |
| Full Name | John M Ricketts |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 49 Years |
| Location | 1231 1st St, Kennett, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053520874 | NPI | - | NPPES |
| 145737701 | Medicaid | AR | |
| 1053520874 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 060608 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Pemiscot County Memorial Hospital | Hayti, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Pemiscot County Memorial Hospital | 8426024159 | 23 |
| Entity Name | Pemiscot County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437251881 PECOS PAC ID: 8426024159 Enrollment ID: O20051005000137 |
| Entity Name | Pemiscot County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578668661 PECOS PAC ID: 8426024159 Enrollment ID: O20070326000204 |
| Mailing Address | Practice Location Address |
|---|---|
| John M Ricketts, CRNA 209 S Main St, Poplar Bluff, MO 63901-5831 Ph: (573) 686-5550 | John M Ricketts, CRNA 1231 1st St, Kennett, MO 63857-2527 Ph: (573) 888-4522 |
Mallory Elizabeth Stith, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1301 1st St, Kennett, MO 63857 Phone: 573-718-4038 | |
Justin Smith, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1301 1st St, Kennett, MO 63857 Phone: 573-686-5550 |