Individual provider Active NPI

Dawn Marshall

  • Certified Registered Nurse Anesthetist
  • Dekalb, IL
National Provider Identifier
1457804692
Registry record updated Jul 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.014549 Issued in IL
Practice address
1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone
(815) 748-2987
NPI assigned
Jul 24, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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.

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates, LTD 34 clinicians
Apollo Anesthesia and Pain Management PLLC 27 clinicians

Practice addresses (Care Compare)

1 Kish Hospital Dr
Dekalb, IL 60115-9602

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone (563) 742-5000

Hospital & facility affiliations

  • Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104

Medicare participation

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

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20170307002212 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153605324 Reassigns benefits to 4 organizations
I20220721000784 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153605324 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209.014549ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Pain Care Centers LTD CurrentSince Jun 13, 2017 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Apollo Anesthesia and Pain Management, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
Anesthesia Associates, LTD CurrentSince Jan 8, 2017 Accepting new patients

Locations

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

600 N College Ave
Geneseo, IL 61254
Phone (309) 944-6431

520 Valley View Dr
Ste 300
Moline, IL 61265
Phone (309) 762-1952

100 5th St
Oswego, IL 60543
Phone (630) 449-0085

1879 N Neltnor Blvd
West Chicago, IL 60185

Interoperability endpoints

  • Direct secure messaging: dmarshall894470@direct.unitypoint.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209.014549 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

1 Kish Hospital Dr
Dekalb, IL 60115-9602

Mailing address

540 Cloverlane Dr
Sycamore, IL 60178-2302
Phone (815) 519-3259

Other names 1

NPPES NPI Registry
  • Dawn M Dirksen Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 24, 2016.

{
    "created_epoch": "1469318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469318400000",
    "number": "1457804692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 CLOVERLANE DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601782302",
            "telephone_number": "815-519-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-748-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-24",
        "last_updated": "2016-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.014549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "DIRKSEN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2016; 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.