G & G Anesthesia LLC
Organization Active NPI Certified Registered Nurse Anesthetist · Maryville, IL
NPI 1487020111 · NPPES record last updated Feb 27, 2026
Key facts
- NPI
- 1487020111
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 209007445 (IL)
- Legal business name
- G & G ANESTHESIA LLC
- Practice address
- 2023 Vadalabene Dr Ste 350
Maryville, IL 62062-5637 - Phone
- (618) 205-8302
- NPI assigned
- Aug 17, 2015
- Organization subpart
- No
Authorized official
- Name
- Randy Pruetzel
- Title
- Manager
- Phone
- (618) 205-8304
Practitioners 178
-
Jessica Joann Anderson, CRNA
-
Paige Arendt, CRNA
-
Russell Craig Arendt, CRNA
-
Cory Ray Austin, CRNA, DNP
-
Jennifer Lynn Clevenger, CRNA
-
Scott Andrew Girard, M.D.
-
Allison Magnuson, MD
-
Rinki Mahay, M.D.
-
Cassandra Myers, CRNA
-
Joseph Michael Logan Oldani, DNP-NA, CRNA
-
Melissa Kate Render, CRNA
-
Betty Sagovac, CRNA
-
Megan E Sims, DNP, CRNA
-
Brenna M Thomas, CRNA
-
Vonda K Walker, CRNA
-
Britley Ann White, CRNA
-
Jenna M Winters, CRNA
-
Wade Bilger, CRNA
-
Angela M Bostic, CRNA
-
Joelle Boucaud, CRNA
-
Megen Marie Brown, CRNA
-
Karen Brooke Campbell, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in IL, NM, MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150930000831 | IL | Part B Supplier - Clinic/Group Practice | 4981912607 |
Receives reassigned benefits from 143 practitioners Practice locations: Marion, IL; Red Bud, IL; Mount Vernon, IL; Maryville, IL; Herrin, IL; Granite City, IL; Glen Carbon, IL; Edwardsville, IL… |
| O20191220000506 | NM | Part B Supplier - Clinic/Group Practice | 4981912607 |
Receives reassigned benefits from 15 practitioners Practice locations: Deming, NM |
| O20210204002043 | MO | Part B Supplier - Clinic/Group Practice | 4981912607 |
Receives reassigned benefits from 10 practitioners Practice locations: Cape Girardeau, MO; Weldon Spring, MO |
National Provider Directory
Locations
3241 Percy Dr
Cpe Girardeau, MO 63701
Phone (573) 334-1222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist |
367500000X | 209007445 | IL | Yes |
Addresses
Primary practice location
2023 Vadalabene Dr Ste 350
Maryville, IL 62062-5637
Mailing address
2023 Vadalabene Dr Ste 350
Maryville, IL 62062-5637
Phone (618) 205-8302
Other providers in Maryville, IL
- Olivia Anne Frawley
- Daniel Lynn Free
- Jocelyn Freeman
- Danielle Nicole Fries
- Megan Rae Fulling
- Kelley Marie Gaither
- Marjorie Kaye Garcia
- Melanie Garland
- Brandi Garlich
- Jamie Lee Garman
All providers in Maryville, IL · Certified Registered Nurse Anesthetist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.