Richard Earl Boren, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209-005603 Issued in IL

Practice address

2 S Hospital Dr
Murphysboro, IL 62966-3333

Phone

(618) 684-3156

Fax

(618) 529-0529

NPI assigned

Aug 16, 2006

Last updated

Sep 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rboren14058@sih.direct-ci.com

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.

• Marion Anesthesia Company LLC

  • Certified Registered Nurse Anesthetist
  • Marion, IL
  • NPI 1790721579

  Nurse Anesthetist, Certified Registered

  NPD
• Southern Illinois Medical Services, NFP

  dba SIH Medical Group

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  NPD
• Northstar Anesthesia of Illinois, LLC

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1962822395

  Nurse Anesthetist, Certified Registered

  NPD
• Southern Illinois Hospital Services

  dba Herrin Hospital

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  NPD (past)
• Anesthesia and Pain Management Assoc., P.a.

  • Anesthesiology Physician
  • Searcy, AR
  • NPI 1689621245
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1346353117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S HOSPITAL DR",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629663333",
            "telephone_number": "618-684-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S HOSPITAL DR",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629663333",
            "telephone_number": "618-684-3156",
            "fax_number": "618-529-0529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 W Jackson St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011462",
            "country_code": "US",
            "telephone_number": "618-549-0721 x65137",
            "fax_number": "618-529-0449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171 x35270",
            "fax_number": "618-651-4919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 W Main St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011031",
            "country_code": "US",
            "telephone_number": "610-835-1730",
            "fax_number": "618-457-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOREN",
        "first_name": "RICHARD",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-005603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MULTISPECIALTY GROUP PTAN",
            "identifier": "214881",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rboren14058@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "201 S 14th St",
            "address_2": "Southern Illinois Medical Services NFP",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rboren14058@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson St",
            "address_2": "SIH Medical Group Anesthesiology",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rboren14058@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2601 W Main Street",
            "address_2": "The Physicians' Surgery Center",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rboren14058@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2 S Hospital Dr",
            "address_2": "SIH Medical Group Anesthesiology",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Evan Tep Belfer, MD
• Frederick Gower Bierer, R PH
• Donna L Blache, LCSW
• Dale W Blaise, MD
• Melinda Luanne Bloos, PH.D.
• Andrea Deneen Brewer, PMHNP-BC
• Zeppelyn Dawn Brewer, M.S. CCC-SLP
• Kimberly Renee McCutchen Brooks, LCSW
• Russell W Brown II, PA-C
• Linda Ann Bunselmeyer, MS, OTR/L

• Certified Registered Nurse Anesthetist in Murphysboro, IL
• Providers in Murphysboro, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.