| Mr Levi A Kelly, CRNA | |
|
315 S Osteopathy Ave, Kirksville, MO 63501-6401 | |
| (660) 785-1098 | |
| (660) 665-0333 |
| Full Name | Mr Levi A Kelly |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 15 Years |
| Location | 315 S Osteopathy Ave, Kirksville, 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 |
|---|---|---|---|
| 1194044776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2005008072 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northeast Regional Medical Center | Kirksville, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Missouri Hb Medical Services Llc | 2668813197 | 62 |
| Midwest Anesthesia Providers Sc | 9830480581 | 148 |
| Entity Name | Midwest Anesthesia Providers Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295189082 PECOS PAC ID: 9830480581 Enrollment ID: O20160712001846 |
| Entity Name | Capital Anesthesia Solutions Of Missouri, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770185472 PECOS PAC ID: 1456764885 Enrollment ID: O20210104001560 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Levi A Kelly, CRNA 1007 Kings Rd, Kirksville, MO 63501-2627 Ph: () - | Mr Levi A Kelly, CRNA 315 S Osteopathy Ave, Kirksville, MO 63501-6401 Ph: (660) 785-1098 |
Charlotte M Cowan, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 W Jefferson St, Northeast Regional Medical Center, Kirksville, MO 63501 Phone: 660-785-1000 Fax: 660-785-1237 | |
Mr. John L Williams, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 315 S Osteopathy Ave, Kirksville, MO 63501 Phone: 660-785-1098 Fax: 660-665-0333 |