Individual provider Active NPI

Vonda K Walker, CRNA

  • Certified Registered Nurse Anesthetist
  • Sparta, IL
National Provider Identifier
1679674857
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209003936 Issued in IL
Practice address
818 E Broadway St
Sparta, IL 62286-1820
Phone
(618) 443-2177
NPI assigned
Sep 26, 2006
Last updated
Feb 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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 209003936 IL Primary

Addresses

Primary practice location

818 E Broadway St
Sparta, IL 62286-1820

Mailing address

2 Good Samaritan Way Ste 205
Mount Vernon, IL 62864-2476
Phone (618) 899-3869

Other practice location 1

4500 Memorial Drive
Belleville, IL 62223
Phone (618) 257-4076

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050425000814 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870531361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians
G and G Anesthesia LLCGroup PAC ID 4981912607, 92 clinicians

Practice addresses (Care Compare)

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

325 Spring St
Red Bud, IL 62278-1105
Phone (618) 282-3831

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
G & G Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 9, 2024 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Jan 13, 2026 Accepting new patients
Midwest Anesthesia Inc. Past Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

325 Spring St
Redbud, IL 62278
Phone (618) 282-5165

Organizations & group practices 3

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 2

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1679674857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GOOD SAMARITAN WAY STE 205",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642476",
            "telephone_number": "618-899-3869",
            "fax_number": "618-899-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 E BROADWAY ST",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "622861820",
            "telephone_number": "618-443-2177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Memorial Drive",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "62223",
            "country_code": "US",
            "telephone_number": "618-257-4076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "VONDA",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209003936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.