Individual provider Active NPI

Daniel R Brown, CRNA

  • Certified Registered Nurse Anesthetist
  • Peoria, IL
National Provider Identifier
1750165973
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209-035696 Issued in IL
Practice address
5620 N Mar Vista Dr
Peoria, IL 61614-3847
Phone
(207) 692-3969
NPI assigned
Aug 21, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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 209-035696 IL Primary

Addresses

Primary practice location

5620 N Mar Vista Dr
Peoria, IL 61614-3847

Mailing address

5620 N Mar Vista Dr
Peoria, IL 61614-3847
Phone (207) 692-3969

Other practice location 1

6742 N Frostwood Pkwy
Peoria, IL 61615-2402
Phone (309) 692-5393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5620 N Mar Vista Dr
Peoria, IL 61614-3847

6742 N Frostwood Pkwy
Peoria, IL 61615-2402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209-035696ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists, S.C. CurrentSince Jun 22, 2026 Accepting new patients
Associated Anesthesiologists, SC CurrentSince Jun 22, 2026 Accepting new patients

Locations

6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1750165973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 N MAR VISTA DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143847",
            "telephone_number": "207-692-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 N MAR VISTA DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143847",
            "telephone_number": "207-692-3969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6742 N Frostwood Pkwy",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616152402",
            "country_code": "US",
            "telephone_number": "309-692-5393",
            "fax_number": "309-683-9998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DANIEL",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-21",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-035696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.