NPIMap

Individual provider Active NPI

Lauren Revelle Remley, CRNA

  • Certified Registered Nurse Anesthetist
  • Decatur, IL
National Provider Identifier
1508129206
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209009657 Issued in IL
Practice address
2300 N Edward St
Decatur, IL 62526-4192
Phone
(217) 876-2575
Fax
(217) 876-2587
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209009657 IL Primary

Addresses

Primary practice location

2300 N Edward St
Decatur, IL 62526-4192

Mailing address

2300 N Edward St
Decatur, IL 62526-4192
Phone (217) 876-2575

Other identifiers 1

IdentifierTypeStateIssuer
041.353404OtherILRN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130321000547 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931344918 Reassigns benefits to 3 organizations

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
Decatur Memorial HospitalGroup PAC ID 6204731144, 173 clinicians

Practice addresses (Care Compare)

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.88 of 100Reported as group
Quality
63.91
Improvement activities
40
Cost
77.03

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association CurrentSince Jan 20, 2025 Accepting new patients
Decatur Memorial Hospital CurrentSince Jun 29, 2022 Accepting new patients
Gibson Community Hospital Association CurrentSince Jan 20, 2025 Accepting new patients
Decatur Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Jun 29, 2022 Accepting new patients
Gibson Community Hospital Association Current Accepting new patients

Locations

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

1800 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 464-2729

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

1302 Franklin Ave
Ste 1000
Normal, IL 61761
Phone (309) 268-3400

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 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1508129206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264192",
            "telephone_number": "217-876-2575",
            "fax_number": "217-876-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264192",
            "telephone_number": "217-876-2575",
            "fax_number": "217-876-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMLEY",
        "first_name": "LAUREN",
        "middle_name": "REVELLE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209009657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041.353404",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.

Verify at the official NPI Registry.