Individual provider Active NPI

Bradley Alan Kirkenir, CRNA

  • Certified Registered Nurse Anesthetist
  • Peoria, IL
National Provider Identifier
1023444866
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
20910728 Issued in IL
Practice address
7309 N Knoxville Ave
Peoria, IL 61614-2085
Phone
(217) 528-7541
NPI assigned
Sep 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 20910728 IL Primary

Addresses

Primary practice location

7309 N Knoxville Ave
Peoria, IL 61614-2085

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Other practice location 1

800 E Carpenter St
Room 2k64
Springfield, IL 62769-0002
Phone (217) 525-5643

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bkirkenir131588@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131104001372 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052546777 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians

Practice addresses (Care Compare)

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20910728ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Jun 4, 2022 Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 1, 2026 Accepting new patients
Carle West Physician Group Inc CurrentSince Jul 1, 2020 Accepting new patients
Springfield Clinic, LLP CurrentSince Apr 13, 2024 Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

7309 N Knoxville Ave
Peoria, IL 61614
Phone (309) 282-0827

800 E Carpenter St
Rm 2K
Springfield, IL 62769
Phone (217) 525-5643

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

800 E Carpenter St
Rm 2K64
Springfield, IL 62769
Phone (217) 525-5643

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Interoperability endpoints

  • Direct secure messaging: bkirkenir131588@ewd.direct.hshs.org
  • Direct secure messaging: bradley.kirkenir.1@28977.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1023444866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142085",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E Carpenter St",
            "address_2": "Room 2k64",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627690002",
            "country_code": "US",
            "telephone_number": "217-525-5643",
            "fax_number": "217-544-3311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKENIR",
        "first_name": "BRADLEY",
        "middle_name": "ALAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-25",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "20910728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkirkenir131588@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "800 E Carpenter St",
            "address_2": "Room 2k64",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627690002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.