Gregory Willis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209-001819 Issued in IL

Practice address

200 Stahlhut Dr
Lincoln, IL 62656-5066

Phone

(217) 732-2161

Fax

(217) 735-3526

NPI assigned

Apr 20, 2007

Last updated

Mar 30, 2011By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Abraham Lincoln Memorial Hospital

  • Certified Registered Nurse Anesthetist
  • Lincoln, IL
  • NPI 1558586180

  Nurse Anesthetist, Certified Registered

  NPD

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1740408475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 STATE ROUTE 121",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626565355",
            "telephone_number": "217-792-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 STAHLHUT DR",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626565066",
            "telephone_number": "217-732-2161",
            "fax_number": "217-735-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "GREGORY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-001819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RECERTIFICATION OF CRNA",
            "identifier": "37699",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co. (Walgreens #5976)
• William Todd Walker, DMD
• Walmart Inc.
• Damon Paul Walton, DC
• Christina A Ward, LCPC
• W James Wilmert, D.D.S, M.S.
• Lynnette Marie Witherell, COTA/L
• Marsha K. Woodruff, D.D.S.
• Thomas J Zwilling, M.D.

• Certified Registered Nurse Anesthetist in Lincoln, IL
• Providers in Lincoln, 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 Mar 30, 2011; 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.