Active NPI
Gregory Reynolds, C.R.N.A.
- Certified Registered Nurse Anesthetist
- Breese, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 41356803
- Practice address
- 9515 Holy Cross LN
Breese, IL 62230-3618 - Phone
- (618) 526-4511
- NPI assigned
- Jul 12, 2006
- Last updated
- Jan 3, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 41356803 | IL | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 074946 | MO |
Addresses
Primary practice location
9515 Holy Cross LN
Breese, IL 62230-3618
Mailing address
PO Box 456
Albers, IL 62215-0456
Phone (618) 248-5040
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | greynolds245933@ewd.direct.hshs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100
9515 Holy Cross LN
Breese, IL 62230-3618
Phone (618) 526-4511
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41356803 | IL | MD | Certified Registered Nurse Anesthetist |
| 074946 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North American Partners in Anesthesia (Illinois), LLC | Current | Accepting new patients | |
| St Josephs Hospital Breese of the Hospital Sisters of the Third Orde | Past | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
9515 Holy Cross Ln
Saint Rose, IL 62230
Phone (618) 526-4511
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
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.
-
- Anesthesiology Physician
- Oak Park, IL
- NPI 1699032524
-
dba Clinton County Rural Health
- Rural Health Clinic/Center
- Breese, IL
- NPI 1013002658
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Clinton County Rural Health
- Rural Health Clinic/Center
- Breese, IL
- NPI 1013002658
Hospital
-
dba St. Joseph's Hospital
- General Acute Care Hospital
- Breese, IL
- NPI 1457319154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1740205871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 456",
"city": "ALBERS",
"state": "IL",
"postal_code": "622150456",
"telephone_number": "618-248-5040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9515 HOLY CROSS LN",
"city": "BREESE",
"state": "IL",
"postal_code": "622303618",
"telephone_number": "618-526-4511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "GREGORY",
"credential": "C.R.N.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2022-01-03",
"certification_date": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "41356803",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "074946",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "greynolds245933@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "9515 Holy Cross Ln",
"city": "Breese",
"state": "IL",
"country_code": "US",
"postal_code": "622303618",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Breese, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.