Provider Demographics
NPI: | 1407874910 |
---|---|
Name: | SCHUETT, SCOTT J (CRNA) |
Entity type: | Individual |
Prefix: | MR |
First Name: | SCOTT |
Middle Name: | J |
Last Name: | SCHUETT |
Suffix: | |
Gender: | |
Credentials: | CRNA |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 7412011 |
Mailing Address - Street 2: | |
Mailing Address - City: | CHICAGO |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60674-2011 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 800-862-9980 |
Mailing Address - Fax: | 314-362-1185 |
Practice Address - Street 1: | 1 BARNES JEWISH HOSPITAL PLZ |
Practice Address - Street 2: | DEPT ANESTHESIOLOGY |
Practice Address - City: | SAINT LOUIS |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63110-1003 |
Practice Address - Country: | US |
Practice Address - Phone: | 800-862-9980 |
Practice Address - Fax: | 314-362-1185 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-17 |
Last Update Date: | 2025-04-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MO | 101414 | 367500000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MO | 918357104 | Medicaid | |
IL | ENROLLED | Medicaid | |
IL | $$$$$$$$$001 | Medicaid | |
MO | 023060042 | Medicaid | |
MO | 023060042 | Medicare PIN |