Individual provider Active NPI

Wyatt Robinson, CRNA

  • Certified Registered Nurse Anesthetist
  • Vienna, IL
National Provider Identifier
1548944614
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209032726 Issued in IL
Practice address
325 Old Bloomfield Rd
Vienna, IL 62995-2619
Phone
(618) 771-6004
NPI assigned
Jun 9, 2023
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X 209032726 IL Primary

Addresses

Primary practice location

325 Old Bloomfield Rd
Vienna, IL 62995-2619

Mailing address

325 Old Bloomfield Rd
Vienna, IL 62995-2619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250809000299 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769980713 Reassigns benefits to 1 organization
I20250908002071 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769980713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians
Apex Anesthesia Partners PLLCGroup PAC ID 3476891656, 34 clinicians

Practice addresses (Care Compare)

117 E Clark St
Harrisburg, IL 62946-2702
Phone (618) 252-0411

1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 756-1000

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156

201 S 14TH St
Herrin, IL 62948-3631
Phone (618) 942-2171

2501 Kentucky Ave
Paducah, KY 42003-3813
Phone (270) 575-2100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Anesthesia Partners, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 21, 2025 Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2025 Accepting new patients

Locations

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322

2501 Kentucky Ave
Paducah, KY 42003
Phone (270) 575-2180

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1548944614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 OLD BLOOMFIELD RD",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629952619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 OLD BLOOMFIELD RD",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629952619",
            "telephone_number": "618-771-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "WYATT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-09",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209032726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.

Verify at the official NPI Registry.