NPIMap

Individual provider Active NPI

Karen Lynette Sedgwick, CRNA

  • Certified Registered Nurse Anesthetist
  • East Peoria, IL
National Provider Identifier
1881619963
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
041323901 Issued in IL
Practice address
111 W Washington St
Suite 310
East Peoria, IL 61611-2532
Phone
(309) 699-4715
NPI assigned
Jul 12, 2006
Last updated
Jul 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 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 041323901 IL Primary

Addresses

Primary practice location

111 W Washington St
Suite 310
East Peoria, IL 61611-2532

Mailing address

111 W Washington St
Suite 310
East Peoria, IL 61611-2532
Phone (309) 699-4715

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060911000018 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628072402 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

525 E Grant St
Macomb, IL 61455-3313
Phone (309) 833-4101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041323901ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jan 13, 2021 Accepting new patients
McDonough County Hospital District CurrentSince May 31, 2013 Accepting new patients
Elysian Hospice, Inc Current Accepting new patients
Clinical Colleagues LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 4, 2020 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Nurse Anesthetist, Certified Registered CurrentSince May 31, 2013 Accepting new patients
Visidoc, LLC CurrentSince Jun 17, 2022 Accepting new patients
Clinical Colleagues LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 4, 2020 Accepting new patients
Methodist Medical Center of Illinois Past Accepting new patients
Pekin Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

111 W Washington St
Ste 310
East Peoria, IL 61611
Phone (309) 699-4715

695 N Kellogg St
Galesburg, IL 61401
Phone (309) 343-0557

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/

Organizations & group practices 14

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.

View all 14

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1881619963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W WASHINGTON ST",
            "address_2": "SUITE 310",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112532",
            "telephone_number": "309-699-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W WASHINGTON ST",
            "address_2": "SUITE 310",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112532",
            "telephone_number": "309-699-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDGWICK",
        "first_name": "KAREN",
        "middle_name": "LYNETTE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041323901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.