Active NPI
Nicholas Bernard Girdner, CRNA
- Certified Registered Nurse Anesthetist
- Belleville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2001018420
- Practice address
- 211 S 3Rd St
Belleville, IL 62220-1915 - Phone
- (618) 234-2120
- Fax
- (618) 641-5410
- NPI assigned
- Feb 15, 2007
- Last updated
- Oct 18, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2001018420 | MO | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 209007897 | IL |
Addresses
Primary practice location
211 S 3Rd St
Belleville, IL 62220-1915
Mailing address
751 Sappington Bridge Rd
Sullivan, MO 63080-2354
Phone (314) 607-1473
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 918368408 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209007897 | IL | MD | Certified Registered Nurse Anesthetist |
| 2001018420 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri Baptist Hospital of Sullivan | Current | Accepting new patients | |
| Metro-West Anesthesia Group Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Midwest Anesthesia Providers S.C | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| North American Partners in Anesthesia (Illinois), LLC | Current | Accepting new patients | |
| Missouri Baptist Hospital of Sullivan | Current | Accepting new patients | |
| Anesthesia Partners, LTD. | Past | Accepting new patients | |
| Missouri Baptist Hospital of Sullivan | Past | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438
9515 Holy Cross Ln
Saint Rose, IL 62230
Phone (618) 526-4511
800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643
12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360
1101 W Liberty St
Farmington, MO 63640
Phone (573) 705-1272
2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850
6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442
751 Sappington Bridge Rd
Sullivan, MO 63080
Phone (573) 468-1343
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
Interoperability endpoints
- https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 7
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.
-
- Anesthesiology Physician
- Springfield, IL
- NPI 1699032524
-
- Anesthesiology Physician
- Chesterfield, MO
- NPI 1245427335
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1295189082
Nurse Anesthetist, Certified Registered
-
dba Missouri Baptist Sullivan Hospital
- Multi-Specialty Clinic/Center
- Sullivan, MO
- NPI 1215945480
-
dba Missouri Baptist Sullivan Hospital
- Ambulance
- Sullivan, MO
- NPI 1831343268
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1043270465
-
dba Cuba Medical Office
- Rural Health Clinic/Center
- Cuba, MO
- NPI 1396827408
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba HSHS St. Elizabeth's Hospital
- General Acute Care Hospital
- O'Fallon, IL
- NPI 1629057302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476748800000",
"number": "1871636332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "751 SAPPINGTON BRIDGE RD",
"city": "SULLIVAN",
"state": "MO",
"postal_code": "630802354",
"telephone_number": "314-607-1473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 S 3RD ST",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622201915",
"telephone_number": "618-234-2120",
"fax_number": "618-641-5410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIRDNER",
"first_name": "NICHOLAS",
"middle_name": "BERNARD",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2016-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2001018420",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209007897",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "918368408",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.