| Mr Nathan S Larson, CRNA | |
|
100 Hospital Dr, Lebanon, MO 65536-9210 | |
| (417) 533-6100 | |
| (417) 533-6021 |
| Full Name | Mr Nathan S Larson |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 14 Years |
| Location | 100 Hospital Dr, Lebanon, 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 |
|---|---|---|---|
| 1255683777 | NPI | - | NPPES |
| 600420082 | Medicaid | MO | |
| 1255683777 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2013002285 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ssm Health - Good Samaritan Hospital | Mount vernon, IL | Hospital |
| Ssm Health St Mary's Hospital -centralia | Centralia, IL | Hospital |
| Clay County Hospital | Flora, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Good Samaritan Regional Health Center | 1658272059 | 38 |
| St Marys Hospital Centralia Illinois | 6709788920 | 38 |
| Entity Name | Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851390132 PECOS PAC ID: 5294649372 Enrollment ID: O20031113000382 |
| Entity Name | Salem Township Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295739548 PECOS PAC ID: 0840195277 Enrollment ID: O20031126000688 |
| Entity Name | St Marys Hospital Centralia Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770687196 PECOS PAC ID: 6709788920 Enrollment ID: O20040127000118 |
| Entity Name | Marion Anesthesia Company Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790721579 PECOS PAC ID: 3577522010 Enrollment ID: O20041008000899 |
| Entity Name | Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1851390132 PECOS PAC ID: 5294649372 Enrollment ID: O20080529000078 |
| Entity Name | County Of Clay |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1184655136 PECOS PAC ID: 0042101982 Enrollment ID: O20180801002178 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Nathan S Larson, CRNA Po Box 505164, Saint Louis, MO 63150-5164 Ph: (417) 829-4620 | Mr Nathan S Larson, CRNA 100 Hospital Dr, Lebanon, MO 65536-9210 Ph: (417) 533-6100 |
Debra A Hoerth, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 120 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6100 | |
David Houzenga, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 120 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6100 | |
Sara L Kruse, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 100 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6026 | |
Susan Love, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 100 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6100 | |
Janice A Shore, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 100 Hospital Dr, Lebanon, MO 65536 Phone: 800-277-8151 Fax: 336-841-6217 | |
Desiree Calbert, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 100 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6100 |