Individual provider Active NPI

Nathan Tyler Edwards, CRNA

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1912356494
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
041.442743 Issued in IL
Practice address
251 E Huron St
Chicago, IL 60611-2908
Phone
(256) 658-9848
NPI assigned
Jun 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 186574 TN
Registered Nurse 163W00000X 209.014949 IL
Certified Registered Nurse Anesthetist 367500000X 041.442743 IL Primary

Addresses

Primary practice location

251 E Huron St
Chicago, IL 60611-2908

Mailing address

3306 W Schubert Ave
Apt. 1-O
Chicago, IL 60647-1320
Phone (256) 658-9848

Other practice location 1

1201 S Main St
Crown Point, IN 46307-8481
Phone (256) 658-9848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, KY, OH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20161129001468 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406136928 Reassigns benefits to 2 organizations
I20210805001871 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406136928 Reassigns benefits to 1 organization
I20211108001807 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406136928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Group Practice IncGroup PAC ID 1254245137, 396 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2000

4900 Houston Rd
Florence, KY 41042-4824
Phone (859) 212-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.014949ILMDRegistered Nurse
186574TNMDRegistered Nurse
041.442743ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jan 30, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 30, 2019 Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 3, 2016 Accepting new patients
Anesthesia Group Practice, Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 7, 2021 Accepting new patients
Anesthesia Associates of Cincinnati, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

251 E Huron St
Ste 5
Chicago, IL 60611
Phone (312) 926-2280

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

251 E Huron St
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

340 Thomas More Pkwy
Ste 200
Crestview Hills, KY 41017

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

265 Brookview Centre Way
Ste 400
Knoxville, TN 37919
Phone (865) 293-5549

Organizations & group practices 5

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 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": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1912356494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 W SCHUBERT AVE",
            "address_2": "APT. 1-O",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471320",
            "telephone_number": "256-658-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "256-658-9848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 S Main St",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463078481",
            "country_code": "US",
            "telephone_number": "256-658-9848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "NATHAN",
        "middle_name": "TYLER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "186574",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "209.014949",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041.442743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.