{
"Npi": {
"NPI": "1811332588",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KELTNER",
"FirstName": "AMI",
"MiddleName": "MARIE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CRNA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SHERMAN",
"OtherFirstName": "AMI",
"OtherMiddleName": "MARIE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 410273",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KANSAS CITY",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64141-0273",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "913-680-6000",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1318 E 104TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KANSAS CITY",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64131-4504",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "162-565-2008",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/07/2013",
"LastUpdateDate": "07/30/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": "43-557180-121",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": "2013029019",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}