Shawn Michael Wynn

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209.013769 Issued in IL

Practice address

210 W Walnut St
Canton, IL 61520

Phone

(309) 647-5240

NPI assigned

Feb 4, 2016

Sex

Male

Sole proprietor

No

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

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Graham Hospital Association Hospital, Canton, IL, CCN 141356
• Graham Hospital Association Hospital, Canton, IL, CCN 140001

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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 and National Provider Directory roles.

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1780692087
  Medicare reassignment Care Compare group NPD
• Hammond Henry Dist Hospital

  • Critical Access Hospital
  • Geneseo, IL
  • NPI 1457344491
  Medicare reassignment NPD
• Osf Healthcare System

  • Certified Registered Nurse Anesthetist
  • Monmouth, IL
  • NPI 1811016124

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Graham Hospital Association

  • Internal Medicine Physician
  • Galesburg, IL
  • NPI 1710845854
  NPD
• Hammond Henry Dist Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Geneseo, IL
  • NPI 1740397447
  NPD
• Osf Healthcare System

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1508683590
  NPD
• Osf Healthcare System

  • Anesthesiology Physician
  • Kewanee, IL
  • NPI 1932526621

  Nurse Anesthetist, Certified Registered

  NPD

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

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1154117521
  Care Compare affiliation

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1750749826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W WALNUT ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202444",
            "telephone_number": "309-647-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W WALNUT ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "61520",
            "telephone_number": "309-647-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "SHAWN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-04",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.013769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliet Angela Williams, RN, BSN, CNOR, RNFA
• Peirce Lake Williams, PHARMD
• Gail D Williamson, MD
• Angela Wilson, FNP-BC
• Brandon Michael Wright, D.C.
• Muhammad A Zaheer, M.D.
• Zank Chiropractic and Wellness Center LTD.
• Angela K Zank, DC
• David A Zank, DC
• Patrick Zimmerman

• Certified Registered Nurse Anesthetist in Canton, IL
• Providers in Canton, 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 13, 2018; 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.