Individual provider Active NPI

Ryan Stock, M.D.

  • Anesthesiology Physician
  • Carbondale, IL
National Provider Identifier
1134414618
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036.136803 Issued in IL
Practice address
405 W Jackson St
Sih Medical Group Anesthesiology
Carbondale, IL 62903-7646
Phone
(618) 457-5111
NPI assigned
Jun 13, 2011
Last updated
Dec 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2011016799 MO
Anesthesiology Physician 207L00000X 036.136803 IL Primary

Addresses

Primary practice location

405 W Jackson St
Sih Medical Group Anesthesiology
Carbondale, IL 62903-7646

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 549-0721

Other practice location 1

510 Lincoln Drive
SIH Medical Group Anesthesiology
Herrin, IL 62948
Phone (618) 997-6800 ext. 1125

Other practice location 2

2 South Hospital Drive
SIH Medical Services Anesthesiology
Murphysboro, IL 62966
Phone (618) 684-3156 ext. 65137

Other practice location 3

201 S 14th Street
SIH Medical Group Anesthesiology
Herrin, IL 62948
Phone (618) 942-2171 ext. 65137

Other identifiers 1

IdentifierTypeStateIssuer
214881OtherILMULISPECIALTY GROUP PTAN

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address rstock14132@sih.direct-ci.com
Direct Messaging Address rstock14132@sih.direct-ci.com
Direct Messaging Address rstock14132@sih.direct-ci.com
Direct Messaging Address rstock14132@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150820011352 IL Practitioner - Anesthesiology 4880909712 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Southern Illinois University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians

Practice addresses (Care Compare)

1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 756-1000

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156

201 S 14TH St
Herrin, IL 62948-3631
Phone (618) 942-2171

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.136803ILMDAnesthesiology Physician
2011016799MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
G & G Anesthesia LLC CurrentSince Apr 27, 2023 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Jul 8, 2017 Accepting new patients
Northstar Anesthesia of Illinois, LLC Anesthesiology CurrentSince Nov 15, 2022 Accepting new patients
24 On Physicians, PC PastSince Aug 3, 2015 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

405 W Jackson St
Carbondale, IL 62901

405 W Jackson St
#Sih
Carbondale, IL 62901
Phone 6185490721 ext. 65137

201 S 14th St
#Sih
Herrin, IL 62948
Phone 6189422171 ext. 65137

510 Lincoln Dr
#Sih
Herrin, IL 62948
Phone 6189976800 ext. 1125

3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020

2 S Hospital Dr
#Sih
Murphysboro, IL 62966
Phone 6186843156 ext. 65137

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

Organizations & group practices 4

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 4

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": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1134414618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-549-0721",
            "fax_number": "618-529-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "address_2": "SIH MEDICAL GROUP ANESTHESIOLOGY",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629037646",
            "telephone_number": "618-457-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Lincoln Drive",
            "address_2": "SIH Medical Group Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "62948",
            "country_code": "US",
            "telephone_number": "618-997-6800 x1125",
            "fax_number": "618-993-8188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 South Hospital Drive",
            "address_2": "SIH Medical Services Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "62966",
            "country_code": "US",
            "telephone_number": "618-684-3156 x65137",
            "fax_number": "618-529-0529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 S 14th Street",
            "address_2": "SIH Medical Group Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "62948",
            "country_code": "US",
            "telephone_number": "618-942-2171 x65137",
            "fax_number": "618-351-4919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOCK",
        "first_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2020-12-03",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2011016799",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036.136803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULISPECIALTY GROUP PTAN",
            "identifier": "214881",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rstock14132@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson St",
            "address_2": "SIH Medical Group Anesthesiology",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629037646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rstock14132@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "510 Lincoln Drive",
            "address_2": "SIH Medical Group Anesthesiology",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rstock14132@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "201 S 14th Street",
            "address_2": "SIH Medical Group Anesthesiology",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rstock14132@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2 South Hospital Drive",
            "address_2": "SIH Medical Services Anesthesiology",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.