TIMOTHY D FUNDENBERGER CRNA
NPI 1053412601
Nurse Anesthetist, Certified Registered in Blue Springs, MO

Q: What is Timothy Fundenberger's NPI number?

The NPI number for Timothy Fundenberger is 1053412601. It was assigned to this individual provider in the NPPES registry on September 26, 2006.

Q: What is Timothy Fundenberger's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Active since September 26, 2006

1209 NW NORTH RIDGE DR STE B, ANESTHESIA SERVICES OF BLUE SPRINGS, BLUE SPRINGS, MO 64015(816) 988-8415(816) 988-8395 Get Directions Write a Review

NPPES record last updated: January 20, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Timothy D Fundenberger Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY D FUNDENBERGER CRNA (NPI 1053412601) is an individual nurse anesthetist, certified registered in Blue Springs, Missouri, licensed in Missouri (131800) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1053412601

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameTIMOTHY D FUNDENBERGERCredential: CRNA

Location Address1209 NW NORTH RIDGE DR STE B, ANESTHESIA SERVICES OF BLUE SPRINGSBlue Springs, MO 64015-6320

Mailing Address1209 Nw North Ridge Dr Ste B, Anesthesia Services Of Blue SpringsBlue Springs, MO 64015-6320 · (816) 988-8415 · Fax (816) 988-8395

Phone(816) 988-8415

Fax(816) 988-8395

Sole ProprietorNo

Enumeration DateSeptember 26, 2006

Last NPPES UpdateJanuary 20, 2014

✔ NPI 1053412601 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in MO · 131800

Definition

(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.

1209 NW NORTH RIDGE DR STE B, Blue Springs, MO 64015

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Other Identifiers 4

Medicare PINP00297125MO

Medicare PINS559850MO

Medicare PIN430047294

Medicaid918702523MO

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DENISE A WILSON CRNA

Nurse Anesthetist, Certified Registered