Active NPI
Thomas P Nolan, CRNA
- Certified Registered Nurse Anesthetist
- Gibson, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 28124135A
- Practice address
- 1120 N Melvin St
Gibson, IL 60936 - Phone
- (217) 784-4251
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- 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 | 28124135A | IN | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 209.001102 | IL |
Addresses
Primary practice location
1120 N Melvin St
Gibson, IL 60936
Mailing address
20940 Bradford Dr
Mokena, IL 60448-1470
Phone (708) 341-1369
Other practice location 1
20940 Bradford Dr
Mokena, IL 60448-1470
Phone (815) 469-1187
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040624000605 | IL | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6608852413 | Reassigns benefits to 5 organizations |
| I20060724000044 | IN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6608852413 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gibson Community Hospital AssociationAnesthesia Dynamics LLCRedreef Anesthesia Associates Chartered Indiana LLC
Practice addresses (Care Compare)
1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251
4411 Washington Ave
Suite 100
Evansville, IN 47714-0805
Phone (313) 637-9861
600 Grant St
Gary, IN 46402-6001
Phone (888) 851-4642
Hospital & facility affiliations
- Methodist Hospitals Inc
- Gibson Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.001102 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Community Hospital Association | Current | Accepting new patients | |
| Redreef Anesthesia Associates Chartered Indiana LLC | Current | Accepting new patients | |
| Gibson Community Hospital Association | Current | Accepting new patients | |
| Gibson Community Hospital Association | Current | Accepting new patients | |
| Ucm Medical Group Sub, LLC | Current | Accepting new patients | |
| North American Partners in Anesthesia (Illinois), LLC | Current | Accepting new patients | |
| Anesthesia Dynamics LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Illinois Anesthesia Associates PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| American Anesthesiology of Illinois, LLC | Past | Accepting new patients | |
| Windy City Anesthesia PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Windy City Anesthesia PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
12935 Gregory St
Blue Island, IL 60406
Phone (708) 597-2000
27702 Network Pl
Chicago, IL 60673
77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407
2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104
7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500
1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684
1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300
998 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 744-3000
455 W Court St
Ste 300
Kankakee, IL 60901
Phone (815) 939-2033
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389
20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857
1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160
11051 Broadway
Ste B
Crown Point, IN 46307
Phone (219) 308-0193
4411 Washington Ave
Ste 100
Evansville, IN 47714
Phone (313) 637-9861
1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551
8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926
Interoperability endpoints
- tnolan224585@uchospital.direct-ci.com
Organizations & group practices 26
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.
-
- Anesthesiology Physician
- Bradenton, FL
- NPI 1073001012
IN, Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Gary, IN
- NPI 1215783766
IN
-
- Anesthesiology Physician
- Oak Park, IL
- NPI 1699032524
IL
-
- Community/Retail Pharmacy
- Gibson City, IL
- NPI 1245105535
-
- Anesthesiology Physician
- Mokena, IL
- NPI 1962512335
IL
-
- Rural Health Clinic/Center
- Watseka, IL
- NPI 1043720691
-
- Rural Health Clinic/Center
- Forrest, IL
- NPI 1063462976
-
- Rural Health Clinic/Center
- Gibson City, IL
- NPI 1154702181
-
- Rural Health Clinic/Center
- Cissna Park, IL
- NPI 1356884993
-
- Community/Retail Pharmacy
- Gibson City, IL
- NPI 1477570166
Hospital & facility affiliations 24
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Health Clinic/Center
- Watseka, IL
- NPI 1043720691
Hospital
-
- Rural Health Clinic/Center
- Forrest, IL
- NPI 1063462976
Hospital
-
- Pulmonary Disease Physician
- Gibson City, IL
- NPI 1114507753
Hospital
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital
-
- Cardiovascular Disease Physician
- Gibson City, IL
- NPI 1134540750
Hospital
-
- Rural Health Clinic/Center
- Gibson City, IL
- NPI 1154702181
Hospital
-
- Rheumatology Physician
- Gibson City, IL
- NPI 1174262968
Hospital
-
- Medical Oncology Physician
- Gibson City, IL
- NPI 1245979020
Hospital
-
- Rural Health Clinic/Center
- Cissna Park, IL
- NPI 1356884993
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1477592137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20940 BRADFORD DR",
"city": "MOKENA",
"state": "IL",
"postal_code": "604481470",
"telephone_number": "708-341-1369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 N MELVIN ST",
"city": "GIBSON",
"state": "IL",
"postal_code": "60936",
"telephone_number": "217-784-4251"
}
],
"practiceLocations": [
{
"address_1": "20940 Bradford Dr",
"address_purpose": "LOCATION",
"city": "Mokena",
"state": "IL",
"postal_code": "604481470",
"country_code": "US",
"telephone_number": "815-469-1187",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NOLAN",
"first_name": "THOMAS",
"middle_name": "P",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2024-10-25",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IN",
"license": "28124135A",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209.001102",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.