Individual provider Active NPI

Aimee Shane, CRNA

  • Certified Registered Nurse Anesthetist
  • Kewanee, IL
National Provider Identifier
1841502549
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.008194 Issued in IL
Practice address
1051 W South St
Kewanee, IL 61443-8354
Phone
(309) 852-7500
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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 209.008194 IL Primary

Addresses

Primary practice location

1051 W South St
Kewanee, IL 61443-8354

Mailing address

278 Pin Oak CT
Dahinda, IL 61428-9769
Phone (309) 339-1259

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110207000175 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365622529 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4281

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.008194ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Sep 8, 2016 Accepting new patients
Springfield Clinic, LLP CurrentSince Apr 13, 2024 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Sep 3, 2019 Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Sep 8, 2016 Accepting new patients

Locations

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

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

7309 N Knoxville Ave
Peoria, IL 61614
Phone (309) 282-0827

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

Interoperability endpoints

  • Direct secure messaging: ashanecrna393125@carlehiedirect.net

Organizations & group practices 4

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 3

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": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1841502549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 PIN OAK CT",
            "city": "DAHINDA",
            "state": "IL",
            "postal_code": "614289769",
            "telephone_number": "309-339-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 W SOUTH ST",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614438354",
            "telephone_number": "309-852-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANE",
        "first_name": "AIMEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.008194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kewanee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; 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.