DREW MEMORIAL ANESTHESIA SERVICES
NPI 1124074430
Nurse Anesthetist, Certified Registered in Monticello, AR
NPI Status: Active since May 26, 2006
Contact Information
778 SCOGIN DRIVE
MONTICELLO, AR
ZIP 71655
Phone: (870) 367-2411
Fax: (952) 442-3620
- Organization
- Nurse Anesthetist, Certified Registered
- CLIA Number: 04D0678168
- CLIA Cert. Type: Home Health Agency
- CLIA Exp. Date: 08-31-2026
About DREW MEMORIAL ANESTHESIA SERVICES
This page provides the complete NPI Profile along with additional information for Drew Memorial Anesthesia Services, a provider established in Monticello, Arkansas operating as a Nurse Anesthetist, Certified Registered. The healthcare provider is registered in the NPI registry with number 1124074430 assigned on May 2006. The practitioner's primary taxonomy code is 367500000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Drew Memorial Anesthesia Services. The authorized official of this NPI record is Shannon R Clark (Cfo)
- NPI
- 1124074430
- Provider Legal Name
- DREW COUNTY MEMORIAL HOSPITAL
- Other Organization Name
- DREW MEMORIAL ANESTHESIA SERVICES
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 778 SCOGIN DRIVE MONTICELLO, AR 71655
- Location Phone
- (870) 367-2411
- Location Fax
- (952) 442-3620
- Mailing Address
- 400 EAST 10TH STREET WACONIA, MN 55387
- Mailing Phone
- (952) 442-9770
- Mailing Fax
- (952) 442-3620
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-26-2006
- Last Update Date
- 10-25-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Anesthetist, Certified Registered
- Taxonomy Code
- 367500000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- Taxonomy Description
- (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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 159964002 | MEDICAID (05) | AR | |
| 5F446 | MEDICARE ID-TYPE UNSPECIFIED (04) | AR | |
| 5F446 | OTHER (01) | AR | BLUE CROSS OF AR |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 04D0678168
- Facility Type
- Home Health Agency
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- KARON BEAVERS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Drew Memorial Anesthesia Services to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124074430, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
MONTICELLO, AR 71655
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124074430, enumerated as an "organization" on May 26, 2006.
The provider is located at 778 SCOGIN DRIVE MONTICELLO, AR 71655 and the phone number is (870) 367-2411.
Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.
