MS. KELLY R GORDON (NPI# 1063495711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063495711 |
| Entity Type | Individual |
| Full Name | MS. KELLY R GORDON |
| Other Name | MS. KELLY R HUTTON |
| Credential | RN ARNP CRNA |
| Practice Address |
3310 W 10th St Sedalia MO 65301-2111 |
| Mailing Address |
3705 N 139th St Kansas City KS 66109-4234 |
| Practice Telephone | 6608294024 |
| Mailing Telephone | 9137213641 |
| Mailing Fax Number | 9137213649 |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2019-08-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 115622 | MO | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 1358880051 | KS | Nursing Service Providers |
| N | 363L00000X | Nurse Practitioner | 54723 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | 115622 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 54723 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | PREFERRED HEALTH SYSTEMS | 00S23683 | 01 |
| KS | 100403160D | 05 | |
| MO | RAILROAD MEDICARE | P00365458 | 01 |
| COMMUNITY HEALTH PLAN | 100016620001 | 01 | |
| FIRST HEALTH | 5718942 | 01 | |
| KS | RAILROAD MEDICARE | P00401683 | 01 |
| MO | BLUE CROSS BLUE SHIELD KC | 28034048 | 01 |
| KS | TRICARE WPS | 66048A019 | 01 |
| MO | 915400618 | 05 | |
| KS | BLUE CROSS BLUE SHIELD KS | 145353 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3550 S 4th St, Leavenworth, KS 660485071 | 9136806000 | 9133340875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124446505 | Kelly Gordon | Psychiatry & Neurology | 13001 E. 17th Place, Campus Box F546, Bldg. 500, Room E2322, Aurora, CO 80045 | 2014-04-02 |
| 1689811846 | Kelly Alice Gordon | Counselor | 11610 Dancing River Dr, Apt #201, Venice, FL 34292-4131 | 2009-01-09 |
| 1073762704 | Kelly Veronica Gordon | Social Worker | 18947 John J Williams Hwy Unit 212, Rehoboth Beach, DE 19971-4476 | 2008-09-18 |
| 1194349019 | Kelly Marie Gordon | Nurse Practitioner | 1000 E Tarpon Ave, Tarpon Springs, FL 34689-5438 | 2020-06-05 |
| 1285109199 | Kelly Suzanne Gordon | Occupational Therapist | 1101 W University Dr, Rochester, MI 48307-1863 | 2018-10-06 |
| 1598293227 | Kelly Gordon | Case Manager/Care Coordinator | 111 W Booth Rd, Searcy, AR 72143 | 2017-05-25 |
| 1982148912 | Kelly Gordon | Social Worker | 333 9th St, Atlantic Beach, FL 32233-5437 | 2016-12-09 |
| 1003217514 | Kelly Gordon | Counselor | 1280 Main St, Buffalo, NY 14209-1912 | 2014-09-16 |
| 1821376070 | Kelly A Gordon | Speech-Language Pathologist | 42 Huskie Ln, Malone, NY 12953-2451 | 2011-07-21 |
| 1891022182 | Kelly Kathleen Gordon | Nurse Practitioner | 75 Nw Dogwood St, Suite B, Issaquah, WA 98027-3210 | 2009-11-08 |
| Street Address |
3310 W 10TH ST |
| City | SEDALIA |
| State | MO |
| Zip Code | 65301-2111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063493443 | Sedalia Surgery Center, LLC | Clinic/Center | 3310 W 10th St, Sedalia, MO 65301-2111 | 2005-11-11 |
| 1528180791 | Connie E Kiburz | Nurse Anesthetist, Certified Registered | 3310 W 10th St, Sedalia, MO 65301-2111 | 2007-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760024962 | Eve's Doting Doula Care LLC | Doula | 28226 Hwy Tt, Sedalia, MO 65301 | 2019-10-09 |
| 1568938322 | Judith Jean Patrick | Occupational Therapist | 1520 Thompson Blvd, Sedalia, MO 65301 | 2018-10-19 |
| 1558843623 | Teddy Santiago | Contractor | 101b South Wasington, Sedalia, MO 65301 | 2018-09-05 |
| 1063991859 | Empowerme Rehabilitation Mo Agency | Occupational Therapist | 3751 West 10thstreet, Sedalia, MO 65301 | 2018-08-13 |
| 1780174375 | Sarah Elizabeth Cheatham | Specialist/Technologist | 115 W Broadway Blvd Ste 300, Sedalia, MO 65301 | 2018-05-18 |
| 1033617790 | Megan Marie Yonker | Nurse Practitioner | 821 Westwood Dr., Sedalia, MO 65301 | 2018-01-29 |
| 1801326236 | Angel Verlee Hale | Dentist | 4400 S. Limit, Sedalia, MO 65301 | 2017-06-18 |
| 1487192514 | Kami Parney | Emergency Medical Technician, Basic | 601 E 16th Street, Bothwell Regional Health Center, Sedalia, MO 65301 | 2017-02-09 |
| 1407216344 | Sylvia G. Thompson Residence Center, Inc. | Alzheimer Center (Dementia Center) | 975 Mitchell Road, Sedalia, MO 65301 | 2016-03-04 |
| 1174968721 | John Buckley | Physical Therapy Assistant | 1630 Hickory Lane, Sedalia, MO 65301 | 2013-05-08 |
| Find all providers in zip 65301 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841463361 | Travis John Fitzpatrick | Nurse Anesthetist, Certified Registered | 32020 Hill Ln, Sedalia, MO 65301-1081 | 2008-04-04 |
| 1598280166 | Bart D Kuhns | Nurse Anesthetist, Certified Registered | 601 E 14th St, Sedalia, MO 65301-5972 | 2017-08-04 |
| 1396129722 | Chase Belnap | Nurse Anesthetist, Certified Registered | 601 E 14th St, Sedalia, MO 65301-5972 | 2015-07-15 |
| 1528180791 | Connie E Kiburz | Nurse Anesthetist, Certified Registered | 3310 W 10th St, Sedalia, MO 65301-2111 | 2007-04-06 |
| 1013944404 | Jeffrey D Terrell | Nurse Anesthetist, Certified Registered | 601 E 14th St, Sedalia, MO 65301-5972 | 2006-06-28 |
| 1427085802 | Michael R Moulton | Nurse Anesthetist, Certified Registered | 601 E 14th St, Sedalia, MO 65301-5972 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285251066 | Yousra Amor | Nurse Anesthetist, Certified Registered | St Luke's Des Peres Hospital, 2345 Dougherty Ferry Rd, St Louis, MO 63122-3313 | 2020-06-29 |
| 1457970899 | William Moran | Nurse Anesthetist, Certified Registered | 910 Daffodil Ridge Dr, O Fallon, MO 63366-7760 | 2020-04-15 |
| 1437784329 | Apollo Medical Group of Lee's Summit LLC | Nurse Anesthetist, Certified Registered | 2861 Ne Independence Ave Ste 101, Lees Summit, MO 64064-2379 | 2020-03-11 |
| 1780228155 | Olde Cabin Anesthesia | Nurse Anesthetist, Certified Registered | 11525 Olde Cabin Rd Ste 101, Creve Coeur, MO 63141-7146 | 2019-10-29 |
| 1831652049 | Kristin S Turner | Nurse Anesthetist, Certified Registered | 8991 State Highway 171, Carl Junction, MO 64834-6148 | 2019-04-14 |
| 1629536271 | Cameron David Hayter | Nurse Anesthetist, Certified Registered | 1951 N Citation Ave, Springfield, MO 65802-5406 | 2019-03-03 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1548767783 | Chynna Janae Lorusso | Nurse Anesthetist, Certified Registered | 5321 Shaw Ave, Saint Louis, MO 63110-3023 | 2018-04-12 |
| 1689108839 | Todd Aaron Macdonald | Nurse Anesthetist, Certified Registered | 2119 Highlander Dr, Joplin, MO 64804-7005 | 2017-04-14 |
| 1164883468 | James Dwain Holden | Nurse Anesthetist, Certified Registered | 22888 County Road 283, Puxico, MO 63960-7338 | 2016-03-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.