Individual provider Active NPI

Stuart Mitchell Godwin, CRNA

  • Certified Registered Nurse Anesthetist
  • Peoria, IL
National Provider Identifier
1336471267
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209024392 Issued in IL
Practice address
7309 N Knoxville Ave
Peoria, IL 61614-2085
Phone
(217) 528-7541
NPI assigned
Feb 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 60330629 WA
Certified Registered Nurse Anesthetist 367500000X 209024392 IL Primary
Certified Registered Nurse Anesthetist 367500000X 700881 TX

Addresses

Primary practice location

7309 N Knoxville Ave
Peoria, IL 61614-2085

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220329001794 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496921058 Reassigns benefits to 3 organizations
I20251201000412 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496921058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians
Green Anesthesia Iowa PLLCGroup PAC ID 0749771129, 17 clinicians

Practice addresses (Care Compare)

3301 Broadway St
Quincy, IL 62301-3713
Phone (217) 277-3500

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

407 S White St
Henry County Health Center
Mount Pleasant, IA 52641-2263
Phone (319) 385-3141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
700881TXMDCertified Registered Nurse Anesthetist
60330629WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jun 10, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Mar 21, 2022 Accepting new patients
Springfield Clinic, LLP CurrentSince Mar 1, 2025 Accepting new patients
Osf Multi-Specialty Group CurrentSince Mar 21, 2022 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jun 10, 2025 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Current Accepting new patients
Southeast Iowa Regional Medical Center, Inc. CurrentSince Oct 1, 2025 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Southwestern Physician Services LLC Past Accepting new patients
Northstar Anesthesia of Oklahoma, PLLC Past Accepting new patients

Locations

407 S White St
Mt Pleasant, IA 52641
Phone (319) 385-6110

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

7309 N Knoxville Ave
Peoria, IL 61614
Phone (309) 282-0827

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

3301 Broadway St
Quincy, IL 62301
Phone (217) 277-4070

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

Interoperability endpoints

  • Direct secure messaging: sgodwin1200603@direct.unitypoint.org
  • Direct secure messaging: stuart.godwin.1@28977.direct.athenahealth.com

Organizations & group practices 12

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 4

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": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1336471267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142085",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "STUART",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-03",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "60330629",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209024392",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "700881",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 24, 2025; 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.