Individual provider Active NPI

Carol Christie, CRNA

  • Certified Registered Nurse Anesthetist
  • Beaver Dam, WI
National Provider Identifier
1770660227
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
041393 Issued in WI
Practice address
707 S University
Beaver Dam, WI 53916
Phone
(920) 887-7181
Fax
(920) 887-3422
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 041393 WI Primary

Addresses

Primary practice location

707 S University
Beaver Dam, WI 53916

Mailing address

707 S University
Beaver Dam, WI 53916
Phone (920) 887-7181

Other identifiers 1

IdentifierTypeStateIssuer
43335100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090128000324 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082778584 Reassigns benefits to 2 organizations
I20140211000881 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082778584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Windy City Anesthesia PCGroup PAC ID 9234033572, 35 clinicians
Northstar Anesthesia of Indiana LLCGroup PAC ID 1153576905, 130 clinicians

Practice addresses (Care Compare)

10401 S Roberts Rd
Suite 2
Palos Hills, IL 60465-1984
Phone (708) 430-1600

24 Joliet St
Dyer, IN 46311-1705
Phone (219) 865-2141

701 Superior Ave
Munster, IN 46321-4037
Phone (219) 922-4200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
041393WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Nov 11, 2024 Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Nov 11, 2024 Accepting new patients
Northstar Anesthesia of Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2019 Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2016 Accepting new patients
Stoughton Hospital Association Past Accepting new patients

Locations

1338 E 47th St
Chicago, IL 60653
Phone (773) 324-3338

2333 N Harlem Ave
Chicago, IL 60707
Phone (773) 637-1700

10444 S Western Ave
Ste A
Chicago, IL 60643
Phone (773) 238-1126

500 N Michigan Ave
Ste 2100
Chicago, IL 60611
Phone (312) 276-1212

21120 Washington Pkwy
Frankfort, IL 60423
Phone (815) 469-9750

10401 S Roberts Rd
Ste 2
Palos Hills, IL 60465
Phone (708) 430-1600

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

12800 Mississippi Pkwy
Crown Point, IN 46307
Phone (219) 662-5560

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

701 Superior Ave
Munster, IN 46321
Phone (219) 922-4200

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770660227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "53916",
            "telephone_number": "920-887-7181",
            "fax_number": "920-887-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "53916",
            "telephone_number": "920-887-7181",
            "fax_number": "920-887-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIE",
        "first_name": "CAROL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "041393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43335100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.