Active NPI
Jennifer Carroll, CRNA
- Certified Registered Nurse Anesthetist
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209009625
- Practice address
- 8600 N State Route 91
Suite 250
Peoria, IL 61615-9541 - Phone
- (309) 692-5394
- Fax
- (309) 692-2538
- NPI assigned
- Jul 12, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 209009625 | IL | Primary |
Addresses
Primary practice location
8600 N State Route 91
Suite 250
Peoria, IL 61615-9541
Mailing address
8600 N State Route 91
Suite 250
Peoria, IL 61615-9541
Phone (309) 692-5394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-3311
221 NE Glen Oak Ave
Peoria, IL 61636-0001
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100
5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209009625 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Carle Health Care Incorporated | Current | Accepting new patients | |
| North American Partners in Anesthesia (Illinois), LLC | Current | Accepting new patients | |
| Associated Anesthesiologists, S.C. | Current | Accepting new patients | |
| Carle West Physician Group Inc | Current | Accepting new patients | |
| Associated Anesthesiologists, SC | Past | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461
2200 E Washington St
Bloomington, IL 61701
Phone (309) 662-3311
530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393
6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393
8800 State Route 91
Peoria, IL 61615
Phone (309) 683-5000
5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
8600 State Route 91
Ste 250
Peoria, IL 61615
Phone (309) 692-5393
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
Organizations & group practices 7
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.
-
dba Carle Physician Group
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
- Anesthesiology Physician
- Oak Park, IL
- NPI 1699032524
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1558306480
-
- Family Medicine Physician
- Normal, IL
- NPI 1467074138
-
dba Advocate Eureka Hospital
- Critical Access Hospital
- Eureka, IL
- NPI 1184644023
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1023612082
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
dba Proctor Hospital
- General Acute Care Hospital
- Peoria, IL
- NPI 1033116876
-
- Rehabilitation Hospital Unit
- Peoria, IL
- NPI 1134826894
-
dba OSF Saint Joseph Medical Center
- General Acute Care Hospital
- Bloomington, IL
- NPI 1619916806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342051200000",
"number": "1356606594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8600 N STATE ROUTE 91",
"address_2": "SUITE 250",
"city": "PEORIA",
"state": "IL",
"postal_code": "616159541",
"telephone_number": "309-692-5394",
"fax_number": "309-692-2538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8600 N STATE ROUTE 91",
"address_2": "SUITE 250",
"city": "PEORIA",
"state": "IL",
"postal_code": "616159541",
"telephone_number": "309-692-5394",
"fax_number": "309-692-2538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "JENNIFER",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-12",
"last_updated": "2012-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209009625",
"primary": true
}
],
"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 Jul 12, 2012; 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.