NPIMap

Individual provider Active NPI

Shawna Colleen Waterstradt, CRNA

  • Certified Registered Nurse Anesthetist
  • Urbana, IL
National Provider Identifier
1790157014
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209013803 Issued in IL
Practice address
611 W. Park St.
Anesthesiology
Urbana, IL 61801-2500
Phone
(217) 383-3303
Fax
(217) 383-3265
NPI assigned
Oct 26, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209013803 IL Primary
Registered Nurse 163W00000X 041.391110 IL

Addresses

Primary practice location

611 W. Park St.
Anesthesiology
Urbana, IL 61801-2500

Mailing address

611 W. Park St.
BWPC
Urbana, IL 61801-2500
Phone (217) 383-6941

Other names 1

  • Shawna Colleen Creek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160210001164 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416251582 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vigilance Anesthesiologists and Pain Specialists PCGroup PAC ID 4284975541, 6 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4297

1120 N Melvin St
Gibson City, IL 60936-1477

200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-5841

227 N Market St
Paxton, IL 60957-1123
Phone (217) 379-4864

27240 Dutton Rd
Beecher, IL 60401-5054

3 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4030

3315 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-1000

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

3375 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 676-0766

4 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4251

7 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-5500

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.391110ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Vigilance Anesthesiologists & Pain Specialists PC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2025 Accepting new patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association CurrentSince Aug 6, 2017 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Gibson Community Hospital Association CurrentSince Aug 6, 2017 Accepting new patients
Osf Multi-Specialty Group CurrentSince May 19, 2023 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
North American Partners in Anesthesia (Illinois), LLC Past Accepting new patients

Locations

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

200 E Fairman Ave
Watseka, IL 60970
Phone (815) 432-5201

6245 N Old 27
Ste A10
Fremont, IN 46737
Phone (260) 833-6100

Organizations & group practices 11

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.

Hospital & facility affiliations 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790157014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "ANESTHESIOLOGY",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-3303",
            "fax_number": "217-383-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERSTRADT",
        "first_name": "SHAWNA",
        "middle_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209013803",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.391110",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNA",
            "last_name": "CREEK",
            "middle_name": "COLLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.