Individual provider Active NPI

Laura Reedy, CRNA

  • Certified Registered Nurse Anesthetist
  • Marion, IL
National Provider Identifier
1982795043
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1103605 Issued in KY
Practice address
2401 W Main St
Marion, IL 62959-1188
Phone
(618) 997-5311
NPI assigned
Sep 27, 2006
Last updated
Jan 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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 1103605 KY Primary

Addresses

Primary practice location

2401 W Main St
Marion, IL 62959-1188

Mailing address

2401 West Main St.
Marion, IL 62549
Phone (618) 997-5311

Other identifiers 1

IdentifierTypeStateIssuer
74008582MedicaidKY

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
1103605KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Memorial Hospital Past Accepting new patients
Decatur Memorial Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1982795043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 WEST MAIN ST.",
            "city": "MARION",
            "state": "IL",
            "postal_code": "62549",
            "telephone_number": "618-997-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDY",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1103605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74008582",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

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