JOHN M RICKETTS CRNA
NPI 1053520874
Nurse Anesthetist, Certified Registered in Kennett, MO
About John M Ricketts Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN M RICKETTS CRNA (NPI 1053520874) is an individual nurse anesthetist, certified registered in Kennett, Missouri, licensed in Missouri (060608) and active in the NPI registry since May 2007.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
John M Ricketts Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show John Ricketts reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Kennett, MO 63857
- Reassigned Medicare billing, Missouri enrollment
- Also billed through NPI 1437251881 (Missouri)
- 81 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KENNETT, MO 63857
KENNETT, MO 63857
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is John Ricketts's NPI number?
The NPI number for John Ricketts is 1053520874. It was assigned to this individual provider in the NPPES registry on May 21, 2007.
Where is John Ricketts located?
John Ricketts practices at 1231 1st St, Kennett, MO 63857. The listed phone number is (573) 888-4522.
What is John Ricketts's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is John Ricketts enrolled in Medicare?
Yes. John Ricketts is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for John Ricketts's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Ricketts reassigns Medicare benefits to Pemiscot County Memorial Hospital (Kennett, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Ricketts's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for John Ricketts was last updated on August 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# John M Ricketts, CRNA · NPI 1053520874
Nurse Anesthetist, Certified Registered physician in Kennett, Missouri. Individual provider, active in the CMS NPPES registry since May 21, 2007.
## Identity
- **NPI:** 1053520874 (Entity type: Individual)
- **Enumerated:** May 21, 2007
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 060608 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 1231 1ST ST, Kennett, MO 63857-2527
- **Phone:** (573) 888-4522
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Pemiscot County Memorial Hospital (NPI 1992807390, Kennett, MO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 6, 2014
- **Other identifiers:** Medicaid 1053520874 (MO); Medicaid 145737701 (AR); Medicare PIN MA4141001 (MO)
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Source: [NPI Profile](https://npiprofile.com/npi/1053520874) · Data from the CMS NPPES public registry.