| Kevin Hal Liljenquist, | |
|
444 Four States Dr Ste 2, Galena, KS 66739-4325 | |
| (620) 783-4000 | |
| Not Available |
| Full Name | Kevin Hal Liljenquist |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 4 Years |
| Location | 444 Four States Dr Ste 2, Galena, Kansas |
| 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 |
|---|---|---|---|
| 1952041790 | NPI | - | NPPES |
| 910110875 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2022021647 (Missouri) | Primary |
| 163W00000X | Registered Nurse | 2017026396 (Missouri) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Hospital Springfield | Springfield, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Renew Medical Group Of Missouri | 3476043233 | 23 |
| Mercy Hospital Carthage | 8426225251 | 23 |
| Four States Anesthesia Services Llc | 8729973284 | 32 |
| Entity Name | Skaggs Community Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871786905 PECOS PAC ID: 5092624320 Enrollment ID: O20040129000626 |
| Entity Name | Four States Anesthesia Services LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053382929 PECOS PAC ID: 8729973284 Enrollment ID: O20040216000537 |
| Entity Name | Mercy Hospital Aurora |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1467543090 PECOS PAC ID: 9436063211 Enrollment ID: O20061104000261 |
| Entity Name | Mercy Hospital Cassville |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1285676932 PECOS PAC ID: 8820999139 Enrollment ID: O20100118000033 |
| Entity Name | Mercy Hospital Carthage |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003201955 PECOS PAC ID: 8426225251 Enrollment ID: O20120225000071 |
| Entity Name | Mercy Hospital Carthage |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1003201955 PECOS PAC ID: 8426225251 Enrollment ID: O20141203001963 |
| Entity Name | Renew Medical Group of Missouri |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700779121 PECOS PAC ID: 3476043233 Enrollment ID: O20251110000985 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Hal Liljenquist, Po Box 802843, Kansas City, MO 64180-2843 Ph: Not Available | Kevin Hal Liljenquist, 444 Four States Dr Ste 2, Galena, KS 66739-4325 Ph: (620) 783-4000 |
Danielle R Jackson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 444 Four States Dr, Suite 2, Galena, KS 66739 Phone: 620-783-4441 |
Mr. Keanon Walker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 444 Four States Dr, Suite 2, Galena, KS 66739 Phone: 620-783-4000 Fax: 620-783-4188 |
Jonathan Bryan Sperry, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 444 Four States Dr, Suite 1, Galena, KS 66739 Phone: 620-783-4000 |
James Edward Miles, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1619 K66, Galena, KS 66739 Phone: 417-358-8121 |
Kylie D Jennings, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 444 Four States Dr, Galena, KS 66739 Phone: 620-783-4441 |