NPIMap

Individual provider Active NPI

Jane A. Rickman, CRNA

  • Certified Registered Nurse Anesthetist
  • Loves Park, IL
National Provider Identifier
1982609343
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209-001566 Issued in IL
Practice address
2202 Harlem Road
Suite 200
Loves Park, IL 61111-2754
Phone
(815) 877-4848
Fax
(815) 654-5342
NPI assigned
Jun 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041-152963 IL
Certified Registered Nurse Anesthetist 367500000X 209-001566 IL Primary

Addresses

Primary practice location

2202 Harlem Road
Suite 200
Loves Park, IL 61111-2754

Mailing address

2202 Harlem Road
Suite 200
Loves Park, IL 61111-2754
Phone (815) 877-4848

Other identifiers 1

IdentifierTypeStateIssuer
P00944335OtherILRR MEDICARE

Other names 1

  • Ms. Jane A. Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041-152963ILMDRegistered Nurse
209-001566ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Anesthesia Associates, P.C. Past Accepting new patients
Dupage Podiatry Center, P.C. Past Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Dupage Podiatry Center, P.C. Past Accepting new patients
Novamed Surgery Center of Chicago-Northshore, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1982609343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 HARLEM ROAD",
            "address_2": "SUITE 200",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112754",
            "telephone_number": "815-877-4848",
            "fax_number": "815-654-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 HARLEM ROAD",
            "address_2": "SUITE 200",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112754",
            "telephone_number": "815-877-4848",
            "fax_number": "815-654-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKMAN",
        "first_name": "JANE",
        "middle_name": "A.",
        "name_prefix": "Miss",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-152963",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-001566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00944335",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "JOHNSON",
            "middle_name": "A.",
            "prefix": "MS.",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.