Individual provider Active NPI

Mark Nance, CRNA

  • Certified Registered Nurse Anesthetist
  • Peoria, IL
National Provider Identifier
1982010856
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209011635 Issued in IL
Practice address
8600 State Route 91 Ste 250
Peoria, IL 61615-7831
Phone
(309) 692-5393
Fax
(309) 692-2538
NPI assigned
Jul 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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 209011635 IL Primary

Addresses

Primary practice location

8600 State Route 91 Ste 250
Peoria, IL 61615-7831

Mailing address

8600 State Route 91 Ste 250
Peoria, IL 61615-7831
Phone (309) 692-5393

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140820001083 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779701503 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

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

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists, SC CurrentSince Dec 6, 2020 Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 27, 2022 Accepting new patients
Associated Anesthesiologists, S.C. CurrentSince Jun 20, 2016 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

1302 Franklin Ave
Ste 1000
Normal, IL 61761
Phone (309) 268-3400

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

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

8600 State Route 91
Ste 250
Peoria, IL 61615
Phone (309) 692-5393

5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

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 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": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1982010856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 STATE ROUTE 91 STE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157831",
            "telephone_number": "309-692-5393",
            "fax_number": "309-692-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 STATE ROUTE 91 STE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157831",
            "telephone_number": "309-692-5393",
            "fax_number": "309-692-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANCE",
        "first_name": "MARK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-10",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209011635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.

Verify at the official NPI Registry.