Gwendolyn Barr, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

041178830 Issued in IL

Practice address

1459 Olive Rd
Homewood, IL 60430-2411

Phone

(708) 799-7476

Fax

(708) 799-0797

NPI assigned

Aug 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1720193097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 OLIVE RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302411",
            "telephone_number": "708-799-7476",
            "fax_number": "708-799-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 OLIVE RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302411",
            "telephone_number": "708-799-7476",
            "fax_number": "708-799-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARR",
        "first_name": "GWENDOLYN",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041178830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RECERTIFICATION CARD",
            "identifier": "034107",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE LICENSE",
            "identifier": "041178830",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Homewood, IL
• Providers in Homewood, 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 Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.