Active NPI
Paul D Hutsell, CRNA
- Certified Registered Nurse Anesthetist
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209-014114
- Practice address
- 8600 State Route 91 Ste 250
Peoria, IL 61615-7831 - Phone
- (309) 692-5393
- Fax
- (309) 692-2538
- NPI assigned
- Jan 31, 2007
- 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 | 209-014114 | IL | Primary |
Addresses
Primary practice location
8600 State Route 91 Ste 250
Peoria, IL 61615-7831
Mailing address
8600 State Route 91 Ste 250
Peoria, IL 61615-7831
Phone (309) 692-5393
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125929701 | Medicaid | AR | |
| 98333 | Other | AR | ARK BLUE SHIELD |
| 175118 | Other | MO | MO BLUE SHIELD |
| 912753506 | Medicaid | MO |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Anesthesiologists, S.C. | Current | Accepting new patients | |
| Spectrum Health Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Associated Anesthesiologists, SC | Current | Accepting new patients | |
| Principle Anesthesia PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Umass Memorial Medical Group Inc | Past | Accepting new patients |
Locations
430 Maxine Dr
Morton, IL 61550
Phone (309) 266-7600
8600 State Route 91
Ste 250
Peoria, IL 61615
Phone (309) 692-5393
4909 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 674-7546
6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393
530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393
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.
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1558306480
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1023612082
-
- Certified Registered Nurse Anesthetist
- Morton, IL
- NPI 1063128049
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Morton, IL
- NPI 1225792039
Nurse Anesthetist, Certified Registered
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460419200000",
"number": "1245377183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8600 STATE ROUTE 91 STE 250",
"city": "PEORIA",
"state": "IL",
"postal_code": "616157831",
"telephone_number": "309-692-5393",
"fax_number": "309-692-2538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8600 STATE ROUTE 91 STE 250",
"city": "PEORIA",
"state": "IL",
"postal_code": "616157831",
"telephone_number": "309-692-5393",
"fax_number": "309-692-2538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTSELL",
"first_name": "PAUL",
"middle_name": "D",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2016-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209-014114",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "125929701",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARK BLUE SHIELD",
"identifier": "98333",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MO BLUE SHIELD",
"identifier": "175118",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "912753506",
"state": "MO"
}
],
"endpoints": [],
"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 Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.