Individual provider Active NPI

Phillip Guillien

  • Certified Registered Nurse Anesthetist
  • Dubuque, IA
National Provider Identifier
1265999809
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
123934 Issued in IA
Practice address
350 N Grandview Ave
Dubuque, IA 52001-6388
Phone
(507) 459-2358
NPI assigned
Mar 1, 2019
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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 123934 IA Primary

Addresses

Primary practice location

350 N Grandview Ave
Dubuque, IA 52001-6388

Mailing address

350 N Grandview Ave
Dubuque, IA 52001-6388
Phone (507) 459-2358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190711000779 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890020952 Reassigns benefits to 1 organization
I20250509002979 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890020952 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grandview Anesthesia PCGroup PAC ID 0749691335, 15 clinicians

Practice addresses (Care Compare)

350 N Grandview Ave
Unity Point Health Finley Hospital
Dubuque, IA 52001-6388
Phone (563) 582-1881

454 Badger Rd
Hazel Green, WI 53811-9787
Phone (608) 473-1700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
123934IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Grandview Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Dec 19, 2020 Accepting new patients
Dodge Street Anesthesiologists PC Nurse Anesthetist, Certified Registered PastSince May 28, 2019 Accepting new patients

Locations

350 N Grandview Ave
Dubuque, IA 52001
Phone (563) 582-1881

454 Badger Rd
Hazel Green, WI 53811
Phone (563) 557-5930

Organizations & group practices 3

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 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": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1265999809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N GRANDVIEW AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016388",
            "telephone_number": "507-459-2358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N GRANDVIEW AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016388",
            "telephone_number": "507-459-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLIEN",
        "first_name": "PHILLIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "123934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.