Individual provider Active NPI

Thomas J. Cain, CRNA

  • Certified Registered Nurse Anesthetist
  • Mount Vernon, IL
National Provider Identifier
1871773879
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
249438 Issued in TX
Practice address
605 N 12TH St
Mount Vernon, IL 62864-2857
Phone
(618) 241-1108
Fax
(618) 241-3805
NPI assigned
Nov 7, 2007
Last updated
Mar 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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 249438 TX Primary

Addresses

Primary practice location

605 N 12TH St
Mount Vernon, IL 62864-2857

Mailing address

605 N 12TH St
Mount Vernon, IL 62864-2857
Phone (618) 241-1108

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080429000410 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517044928 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (557) 203-1601

2 Good Samaritan Way
Suite 200
Mount Vernon, IL 62864-2476
Phone (618) 899-3869

400 N Pleasant Ave
Centralia, IL 62801-3056
Phone (618) 436-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
249438TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Southern Illinois Surgery Center LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 12, 2017 Accepting new patients
County of Clay CurrentSince Aug 28, 2019 Accepting new patients
County of Clay CurrentSince Aug 28, 2019 Accepting new patients
Ambulatory Surgery Center of Centralia, LLC CurrentSince Jun 1, 2025 Accepting new patients
Good Samaritan Regional Health Center Current Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Jan 4, 2017 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Jan 4, 2017 Accepting new patients
County of Clay Current Accepting new patients
Ambulatory Surgery Center of Centralia, LLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

1045 Martin Luther King Dr
Centralia, IL 62801
Phone (618) 242-3979

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

911 Stacey Burk Dr
Flora, IL 62839
Phone (618) 662-2161

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

2 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 899-4000

2 Good Samaritan Way
Ste 200
Mount Vernon, IL 62864
Phone (618) 899-3869

4225 Lincolnshire Dr
Ste B
Mount Vernon, IL 62864

5 Good Samaritan Way
Mount Vernon, IL 62864
Phone (557) 203-1601

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-2200

Organizations & group practices 10

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 2

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": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1871773879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 N 12TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642857",
            "telephone_number": "618-241-1108",
            "fax_number": "618-241-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N 12TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642857",
            "telephone_number": "618-241-1108",
            "fax_number": "618-241-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "THOMAS",
        "middle_name": "J.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "249438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.