Individual provider Active NPI

Tiffany Youtzy, CRNA

  • Certified Registered Nurse Anesthetist
  • Carthage, IL
National Provider Identifier
1558560680
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
55615 Issued in KS
Practice address
1454 N County Road 2050 E
Carthage, IL 62321-3551
Phone
(217) 357-8500
NPI assigned
Jul 18, 2007
Last updated
Apr 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041-345516 IL
Registered Nurse 163W00000X 14-95155-031 KS
Registered Nurse 163W00000X 2003017943 MO
Certified Registered Nurse Anesthetist 367500000X 55615 KS Primary

Addresses

Primary practice location

1454 N County Road 2050 E
Carthage, IL 62321-3551

Mailing address

1317 Crimson King CT
Geneseo, IL 61254-8647
Phone (309) 945-7095

Other names 1

  • Tiffany Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA, OK3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20081101000038 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759475098 Reassigns benefits to 2 organizations
I20190509000362 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759475098 Reassigns benefits to 2 organizations
I20230308000508 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759475098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians
Anesthesia and Analgesia PCGroup PAC ID 7810887627, 22 clinicians

Practice addresses (Care Compare)

10502 N 110TH E Ave
Owasso, OK 74055-6655
Phone (918) 376-8000

10512 N 110TH E Ave
Bailey Med Ctr
Owasso, OK 74055-6636
Phone (918) 376-8000

1227 E Rusholme St
Davenport, IA 52803-2459
Phone (563) 324-8160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041-345516ILMDRegistered Nurse
14-95155-031KSMDRegistered Nurse
2003017943MOMDRegistered Nurse
55615KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Morrison Community Hospital District Current Accepting new patients
Apollo Anesthesia and Pain Management, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2020 Accepting new patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 7, 2022 Accepting new patients
Anesthesia & Analgesia PC CurrentSince Apr 22, 2019 Accepting new patients
Anesthesia Consulting Services, PA Past Accepting new patients
Ottawa Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2300 53rd Ave
Bettendorf, IA 52722
Phone (563) 332-4422

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

3319 Spring St
Davenport, IA 52807
Phone (319) 359-1641

600 N College Ave
Geneseo, IL 61254
Phone (309) 944-6431

600 N College Ave
Ste 120
Geneseo, IL 61254
Phone (309) 944-5342

520 Valley View Dr
Ste 300
Moline, IL 61265
Phone (309) 762-1952

1027 E Cherry St
Cushing, OK 74023
Phone (918) 225-2915

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

10512 N 110th East Ave
Owasso, OK 74055
Phone (918) 272-1172

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1558560680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 CRIMSON KING CT",
            "city": "GENESEO",
            "state": "IL",
            "postal_code": "612548647",
            "telephone_number": "309-945-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 N COUNTY ROAD 2050 E",
            "city": "CARTHAGE",
            "state": "IL",
            "postal_code": "623213551",
            "telephone_number": "217-357-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUTZY",
        "first_name": "TIFFANY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-345516",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "14-95155-031",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2003017943",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "55615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "SMITH",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carthage, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.