Individual provider Active NPI

Ryan Deushane, CRNA

  • Certified Registered Nurse Anesthetist
  • Canton, IL
National Provider Identifier
1124482252
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.014083 Issued in IL
Practice address
210 W Walnut St
Canton, IL 61520
Phone
(309) 339-8414
NPI assigned
Apr 5, 2016
Last updated
Aug 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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 209.014083 IL Primary

Addresses

Primary practice location

210 W Walnut St
Canton, IL 61520

Mailing address

210 W Walnut St
Canton, IL 61520-2444
Phone (309) 647-5240

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160620001938 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345531497 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

210 W Walnut St
Canton, IL 61520-2444
Phone (309) 647-5240

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209.014083ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists, SC CurrentSince Sep 27, 2021 Accepting new patients
Hammond Henry Dist Hospital CurrentSince Jan 23, 2017 Accepting new patients
Osf Healthcare System CurrentSince Sep 1, 2019 Accepting new patients
Associated Anesthesiologists, S.C. CurrentSince Sep 27, 2021 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Graham Hospital Association CurrentSince Aug 5, 2018 Accepting new patients
Hammond Henry Dist Hospital CurrentSince Jan 23, 2017 Accepting new patients
Allied Anesthesia Associates, P.C. CurrentSince Jul 3, 2019 Accepting new patients
Graham Hospital Association CurrentSince Aug 5, 2018 Accepting new patients
Osf Healthcare System Nurse Anesthetist, Certified Registered Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Aug 1, 2021 Accepting new patients
Osf Healthcare System Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients

Locations

403 S Kennedy Dr
Bradley, IL 60915
Phone (815) 928-9999

175 S Main St
Canton, IL 61520
Phone (309) 647-3937

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

210 W Walnut St
Canton, IL 61520
Phone (309) 647-5240

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

600 N College Ave
Geneseo, IL 61254
Phone (309) 944-6431

1200 Maple Rd
Joliet, IL 60432
Phone (815) 740-1100

1051 W South St
Kewanee, IL 61443
Phone (309) 734-3141

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 12

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

Hospital & facility affiliations 2

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1124482252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W WALNUT ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202444",
            "telephone_number": "309-647-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W WALNUT ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "61520",
            "telephone_number": "309-339-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEUSHANE",
        "first_name": "RYAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.014083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.