Active NPI
Nathaniel James Gibson
- Certified Registered Nurse Anesthetist
- Urbana, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209.026720
- Practice address
- 611 W Park St
Urbana, IL 61801-2529 - Phone
- (217) 383-3311
- NPI assigned
- Jan 25, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 209.026720 | IL | Primary |
Addresses
Primary practice location
611 W Park St
Urbana, IL 61801-2529
Mailing address
4550 Nicklaus Dr Apt 107
Champaign, IL 61822-1507
Phone (217) 369-7916
Other practice location 1
1000 Health Center Dr
Mattoon, IL 61938-4644
Phone (217) 238-4329
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Health Ctr Dr
Mattoon, IL 61938-4644
Phone (217) 258-2525
611 W Park St
Urbana, IL 61801-2500
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.026720 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| Hoopeston Community Memorial Hospital | Current | Accepting new patients | |
| Hoopeston Community Memorial Hospital | Current | Accepting new patients | |
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| Hoopeston Community Memorial Hospital | Current | Accepting new patients | |
| Carle Health Care Incorporated | Current | Accepting new patients |
Locations
701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531
1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389
101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
-
- Internal Medicine Physician
- Hoopeston, IL
- NPI 1043683014
-
- Critical Access Hospital
- Hoopeston, IL
- NPI 1366480873
-
- Rural Health Clinic/Center
- Hoopeston, IL
- NPI 1578504544
-
- Rural Health Clinic/Center
- Greenville, IL
- NPI 1811858970
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Urbana, IL
- NPI 1013071653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756339200000",
"number": "1508572355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4550 NICKLAUS DR APT 107",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618221507",
"telephone_number": "217-369-7916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"city": "URBANA",
"state": "IL",
"postal_code": "618012529",
"telephone_number": "217-383-3311"
}
],
"practiceLocations": [
{
"address_1": "1000 Health Center Dr",
"address_purpose": "LOCATION",
"city": "Mattoon",
"state": "IL",
"postal_code": "619384644",
"country_code": "US",
"telephone_number": "217-238-4329",
"fax_number": "217-258-2186",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GIBSON",
"first_name": "NATHANIEL",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-25",
"last_updated": "2025-08-28",
"certification_date": "2025-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209.026720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Urbana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.