Active NPI
Pamela Sue Palme, CRNA,MSN
- Certified Registered Nurse Anesthetist
- Breese, IL
National Provider Identifier
1396840658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 041314944
- Practice address
- 9515 Holy Cross LN
Breese, IL 62230-3618 - Phone
- (618) 526-5329
- Fax
- (618) 526-2291
- NPI assigned
- Sep 13, 2006
- Last updated
- Jul 31, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 041314944 | IL | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 209004248 | IL |
Addresses
Primary practice location
9515 Holy Cross LN
Breese, IL 62230-3618
Mailing address
504 Kathy LN
New Baden, IL 62265-2025
Phone (618) 910-3104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse, Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209004248 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HSHS Medical Group Inc | Past | Accepting new patients | |
| Specialists in Anesthesia PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
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.
-
- Rural Health Clinic/Center
- Rushville, IL
- NPI 1487719480
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1689619280
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406764800000",
"number": "1396840658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 KATHY LN",
"city": "NEW BADEN",
"state": "IL",
"postal_code": "622652025",
"telephone_number": "618-910-3104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9515 HOLY CROSS LN",
"city": "BREESE",
"state": "IL",
"postal_code": "622303618",
"telephone_number": "618-526-5329",
"fax_number": "618-526-2291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALME",
"first_name": "PAMELA",
"middle_name": "SUE",
"credential": "CRNA,MSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-13",
"last_updated": "2014-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "041314944",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209004248",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Breese, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.