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WICHITA MEDICAL ANESTHESIA LLC
NPI 1083222137
Nurse Anesthetist, Certified Registered in Lawton, OK

Active since July 15, 2020
3617 W GORE BLVD STE C, LAWTON, OK 73505(580) 351-0500(580) 351-0564 Get Directions Write a Review

NPPES record last updated: August 4, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 4, 2020, Jul 16, 2020 (2 updates tracked since 2020).

About Wichita Medical Anesthesia Llc NPPES

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

WICHITA MEDICAL ANESTHESIA LLC (NPI 1083222137) is a healthcare organization registered as a nurse anesthetist, certified registered in Lawton, Oklahoma and active in the NPI registry since July 2020. The organization lists Starla Ross, Administrator, as its authorized official.

NPPES Registry Identity

NPI1083222137
Entity TypeOrganization
Primary Taxonomy367500000X
Legal Business NameWICHITA MEDICAL ANESTHESIA LLC
Location Address3617 W GORE BLVD STE CLawton, OK 73505-6373
Mailing Address3617 W Gore Blvd Ste CLawton, OK 73505-6373 · (580) 351-0500 · Fax (580) 351-0564
Phone(580) 351-0500
Fax(580) 351-0564
Organization SubpartNo
Authorized OfficialStarla RossAdministrator · (580) 351-0500
Enumeration DateJuly 15, 2020
Last NPPES UpdateAugust 4, 20202 updates tracked since enumeration
NPPES CertifiedAugust 4, 2020
✔ NPI 1083222137 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
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.
3617 W GORE BLVD STE C, Lawton, OK 73505
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wichita Medical Anesthesia Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Wichita Medical Anesthesia LLC, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Bradley Maples
Certified Registered Nurse Anesthetist (CRNA)
NPI 1891235271
3401 W GORE BLVD
Lawton, OK 73505
(580) 355-8620
✔ Accepts Medicare0.1 mi
Roger Hanley, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1588656235
5005 SW MALCOM RD
Lawton, OK 73505
(580) 536-4141
✔ Accepts Medicare1.7 mi
John Dew, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1316939960
1003 NW BECONTREE PL
Lawton, OK 73505
(580) 591-1910
✔ Accepts Medicare2.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Wichita Medical Anesthesia LLC's NPI number?

The NPI number for Wichita Medical Anesthesia LLC is 1083222137. It was assigned to this organization in the NPPES registry on July 15, 2020.

Where is Wichita Medical Anesthesia LLC located?

Wichita Medical Anesthesia LLC is located at 3617 W Gore Blvd Ste C, Lawton, OK 73505. The listed phone number is (580) 351-0500.

What is Wichita Medical Anesthesia LLC's specialty?

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

Is Wichita Medical Anesthesia LLC enrolled in Medicare?

Yes. Wichita Medical Anesthesia LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wichita Medical Anesthesia LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Certified Registered Nurse Anesthetist (CRNA), reassign their Medicare billing to Wichita Medical Anesthesia LLC. A 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 the clinician's services. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Wichita Medical Anesthesia LLC was last updated on August 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.