Individual provider Active NPI

Pamela K. Whitehead, CRNA

  • Certified Registered Nurse Anesthetist
  • Springfield, IL
National Provider Identifier
1275521155
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209000327 Issued in IL
Practice address
800 East Carpenter Street
Room 2K64
Springfield, IL 62769-0001
Phone
(217) 525-5643
Fax
(217) 544-2521
NPI assigned
Oct 13, 2005
Last updated
Jan 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0041311537 IL
Certified Registered Nurse Anesthetist 367500000X 209000327 IL Primary

Addresses

Primary practice location

800 East Carpenter Street
Room 2K64
Springfield, IL 62769-0001

Mailing address

800 East Carpenter Street
Room 2K64
Springfield, IL 62769-0001
Phone (217) 525-5643

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pwhitehead131605@ewd.direct.hshs.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110208000685 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284814260 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0041311537ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince May 1, 2022 Accepting new patients
Sangamon Associated Anesthesiologists, S.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643

800 E Carpenter St
Rm 2334
Springfield, IL 62769
Phone (217) 525-5643

800 E Carpenter St
Rm 2K
Springfield, IL 62769
Phone (217) 525-5643

800 E Carpenter St
Rm 2K64
Springfield, IL 62769
Phone (217) 525-5643

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Interoperability endpoints

  • Direct secure messaging: pwhitehead131605@ewd.direct.hshs.org

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1275521155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 EAST CARPENTER STREET",
            "address_2": "ROOM 2K64",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627690001",
            "telephone_number": "217-525-5643",
            "fax_number": "217-544-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 EAST CARPENTER STREET",
            "address_2": "ROOM 2K64",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627690001",
            "telephone_number": "217-525-5643",
            "fax_number": "217-544-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "PAMELA",
        "middle_name": "K.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "0041311537",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209000327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwhitehead131605@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "800 East Carpenter Street",
            "address_2": "Room 2K64",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627690001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.