NPIMap

Individual provider Active NPI

Carolina Botero

  • Certified Registered Nurse Anesthetist
  • Urbana, IL
National Provider Identifier
1992183503
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209012928 Issued in IL
Practice address
1400 W Park St
Urbana, IL 61801-2334
Phone
(217) 337-2000
NPI assigned
May 14, 2015
Last updated
Jan 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209012928 IL Primary
Registered Nurse 163W00000X 041.382117 IL

Addresses

Primary practice location

1400 W Park St
Urbana, IL 61801-2334

Mailing address

1400 W Park St
Urbana, IL 61801-2334
Phone (217) 337-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813011709 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072828474 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4297

1120 N Melvin St
Gibson City, IL 60936-1477

227 N Market St
Paxton, IL 60957-1123
Phone (217) 379-4864

3 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4030

4 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4251

7 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.382117ILMDRegistered Nurse
209012928ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association CurrentSince Aug 29, 2018 Accepting new patients
Gibson Community Hospital Association CurrentSince Aug 29, 2018 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Sep 2, 2020 Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

2200 E Washington St
Bloomington, IL 61701
Phone (309) 661-5111

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1992183503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012334",
            "telephone_number": "217-337-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012334",
            "telephone_number": "217-337-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTERO",
        "first_name": "CAROLINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209012928",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.382117",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.