Individual provider Active NPI

Sherri Blaha, CRNA

  • Certified Registered Nurse Anesthetist
  • Maryville, IL
National Provider Identifier
1275617029
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Practice address
6810 State Route 162
Suite 215
Maryville, IL 62062-8501
Phone
(618) 288-5711
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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 IL Primary

Addresses

Primary practice location

6810 State Route 162
Suite 215
Maryville, IL 62062-8501

Mailing address

1836 Lackland Hill Pkwy
Attnt: Credentialing Department
Saint Louis, MO 63146-3572
Phone (314) 989-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041104000202 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618930314 Reassigns benefits to 2 organizations
I20260623003252 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618930314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Southern Illinois University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Anesthesiology Consultants LLCGroup PAC ID 2961974944, 5 clinicians
G and G Anesthesia LLCGroup PAC ID 4981912607, 92 clinicians
Millennium Anesthesiology Consultants, LLCGroup PAC ID 9133250475, 17 clinicians

Practice addresses (Care Compare)

144 E Eatherton Rd
3Rd Floor
Chesterfield, MO 63005-4016
Phone (314) 492-1112

6800 State Route 162
Maryville, IL 62062-8500
Phone (618) 288-5711

Hospital & facility affiliations

  • Anderson Hospital Hospital, Maryville, IL, CCN 140289

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209000574ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Anesthesiology Consultants, LLC CurrentSince Mar 22, 2010 Accepting new patients

Locations

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

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 and National Provider Directory roles.

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1275617029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 LACKLAND HILL PKWY",
            "address_2": "ATTNT: CREDENTIALING DEPARTMENT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463572",
            "telephone_number": "314-989-0300",
            "fax_number": "314-810-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162",
            "address_2": "SUITE 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628501",
            "telephone_number": "618-288-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAHA",
        "first_name": "SHERRI",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "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.
  • 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.