Active NPI
Joseph Hines, CRNA
- Certified Registered Nurse Anesthetist
- Maryville, IL
National Provider Identifier
1194809954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- Practice address
- 6810 State Route 162
Ste 215
Maryville, IL 62062-8501 - Phone
- (618) 288-5711
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | IL | Primary |
Addresses
Primary practice location
6810 State Route 162
Ste 215
Maryville, IL 62062-8501
Mailing address
1836 Lackland Hill Pkwy
Attnt: Credentialing Dept.
Saint Louis, MO 63146-3572
Phone (314) 989-0300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209000690 | IL | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203379200000",
"number": "1194809954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1836 LACKLAND HILL PKWY",
"address_2": "ATTNT: CREDENTIALING DEPT.",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631463572",
"telephone_number": "314-989-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6810 STATE ROUTE 162",
"address_2": "STE 215",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620628501",
"telephone_number": "618-288-5711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINES",
"first_name": "JOSEPH",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2008-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maryville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.