Ms Kelly R Gordon, RN ARNP CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Kansas City, MO

  1. Home
  2. Nurse Anesthetist - CR
  3. MO
  4. Kansas City
Ms Kelly R Gordon, RN ARNP CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Kansas City, Missouri. She graduated from nursing school in 2000 and has 25 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Dynamos Anesthesia Services Llc, Derrick D. Jones P C and her current practice location is 1318 E 104th St, Kansas City, Missouri. You can reach out to her office (for appointments etc.) via phone at (816) 256-5200.

Ms Kelly R Gordon is licensed to practice in Kansas (license number 54723) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1063495711.

Contact Information

Ms Kelly R Gordon, RN ARNP CRNA
1318 E 104th St,
Kansas City, MO 64131-4504
(816) 256-5200
Not Available

Map and Direction




Provider's Profile

Full NameMs Kelly R Gordon
GenderFemale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience25 Years
Location1318 E 104th St, Kansas City, Missouri
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ms Kelly R Gordon graduated from nursing school in 2000
  NPI Data:
  • NPI Number: 1063495711
  • Provider Enumeration Date: 11/28/2005
  • Last Update Date: 05/01/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 6305748989
  • Enrollment ID: I20040123000572

Medical Identifiers

Medical identifiers for Ms Kelly R Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063495711NPI-NPPES
5718942OtherFIRST HEALTH
28034048OtherMOBLUE CROSS BLUE SHIELD KC
66048A019OtherKSTRICARE WPS
145353OtherKSBLUE CROSS BLUE SHIELD KS
100016620001OtherCOMMUNITY HEALTH PLAN
915400618MedicaidMO
P00401683OtherKSRAILROAD MEDICARE
00S23683OtherKSPREFERRED HEALTH SYSTEMS
100403160DMedicaidKS
P00365458OtherMORAILROAD MEDICARE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 54723 (Kansas)Primary
163W00000XRegistered Nurse 1358880051 (Kansas)Secondary
163W00000XRegistered Nurse 115622 (Missouri)Secondary
367500000XNurse Anesthetist, Certified Registered 115622 (Missouri)Secondary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Dynamos Anesthesia Services Llc105274858914
Derrick D. Jones P C125446720212

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Kelly R Gordon allows following entities to bill medicare on her behalf.
Entity NameLabette County Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336133362
PECOS PAC ID: 5496664369
Enrollment ID: O20031112000344
Entity NameKansas University Physicians Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003858333
PECOS PAC ID: 8921911587
Enrollment ID: O20040401000328
Entity NameAnesthesia Associates Of Kansas City Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174504732
PECOS PAC ID: 1951206168
Enrollment ID: O20050721001069
Entity NameNorthstar Anesthesia Of Kansas Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073942074
PECOS PAC ID: 6901038819
Enrollment ID: O20140408001134
Entity NameDynamos Anesthesia Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1639719180
PECOS PAC ID: 1052748589
Enrollment ID: O20200224000829
Entity NameKansas Anesthesia Providers, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1346977295
PECOS PAC ID: 6305206764
Enrollment ID: O20230717002059

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kelly R Gordon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Kelly R Gordon, RN ARNP CRNA
29800 W 127th St,
Olathe, KS 66061-8636

Ph: (913) 522-0889		Ms Kelly R Gordon, RN ARNP CRNA
1318 E 104th St,
Kansas City, MO 64131-4504

Ph: (816) 256-5200

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Kansas City, MO

Michael S Filla, RN, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2316 E Meyer Blvd, Kansas City, MO 64132
Phone: 816-276-4000    
Kelli A Pryor,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2301 Holmes St, Kansas City, MO 64108
Phone: 816-404-1100    
Sydney L. Overton, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 2316 E Meyer Blvd, Kansas City, MO 64132
Phone: 816-763-5446    Fax: 816-763-8426
Jennifer Lee Hugo Francisco, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 2401 Gillham Rd, Kansas City, MO 64108
Phone: 816-701-5200    Fax: 816-302-9939
Adrienne Jill Rader, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 2316 E Meyer Blvd, Kansas City, MO 64132
Phone: 816-763-5446    Fax: 816-763-8426
Jon R Featherston,
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 2301 Holmes St, Kansas City, MO 64108
Phone: 816-404-1100    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.