Clayton Shick, DNP, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209021336 Issued in IL

Practice address

1100 E Norris Dr
Ottawa, IL 61350-1604

Phone

(815) 433-3100

NPI assigned

Jun 2, 2020

Last updated

Jun 2, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ias Illinois PCGroup PAC ID 9638530991, 79 clinicians

Rockford Gastroenterology Associates LTDGroup PAC ID 9931184082, shared by 2 NPIs, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beloit Health System Hospital, Beloit, WI, CCN 520100

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clayton.shick.p1@direct.rga.nextgenshare.com

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.

• Ias Illinois PC

  • Anesthesiology Physician
  • Geneva, IL
  • NPI 1265118723

  WI

  Medicare reassignment Care Compare group NPD
• Rockford Gastroenterology Associates, LTD.

  • Specialist
  • Rockford, IL
  • NPI 1447207741

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Rockford Gastroenterology Associates, LTD.

  dba Rockford Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Rockford, IL
  • NPI 1871536763
  Medicare reassignment NPD
• Edgerton Hospital and Health Services Inc.

  • Critical Access Hospital
  • Edgerton, WI
  • NPI 1154350049
  Medicare reassignment NPD
• Stateline Anesthesiologists SC

  • Anesthesiology Physician
  • Beloit, WI
  • NPI 1316937519
  Medicare reassignment NPD
• Edgerton Hospital and Health Services Inc

  • Pain Medicine Physician
  • Whitewater, WI
  • NPI 1538845888
  NPD
• Edgerton Hospital and Health Services, Inc

  • Urgent Care Clinic/Center
  • Whitewater, WI
  • NPI 1982496295
  NPD
• Beloit Health System, Inc

  dba janesville medical center

  • Family Medicine Physician
  • Janesville, WI
  • NPI 1407999337
  NPD (past)

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

• Beloit Health System Inc

  dba Beloit Memorial Hospital

  • General Acute Care Hospital
  • Beloit, WI
  • NPI 1982780094
  Care Compare affiliation

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1689298036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 BIRMINGHAM DR",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E NORRIS DR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501604",
            "telephone_number": "815-433-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHICK",
        "first_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209021336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert William Schmidt, D.D.S., F.A.G.D. P.C
• Lisa Marie Schroeder, LCSW, CTTP-1
• Serenityonwheels, Inc. (No)
• Calym Setser
• Tushar S Shah, DDS
• Kayla A Simons, NP
• Richard Douglas Simonson
• Lauren M Sladek, APN
• Sleep Better Inc (Ottawa Smiles)
• Small Hands Building Blocks, Inc.

• Certified Registered Nurse Anesthetist in Ottawa, IL
• Providers in Ottawa, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; 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.