Healthcare Provider Details

I. General information

NPI: 1376884163
Provider Name (Legal Business Name): JAYME H. THORPE CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2013
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW R D MIZE RD
BLUE SPRINGS MO
64014-2513
US

IV. Provider business mailing address

1201 WAKARUSA DR STE A3
LAWRENCE KS
66049-3889
US

V. Phone/Fax

Practice location:
  • Phone: 816-228-5900
  • Fax:
Mailing address:
  • Phone: 785-856-6170
  • Fax: 785-856-6171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number761346
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number105641
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: