GREGORY WILLIS (NPI# 1740408475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740408475 |
| Entity Type | Individual |
| Full Name | GREGORY WILLIS |
| Credential | CRNA |
| Practice Address |
200 Stahlhut Dr Lincoln IL 62656-5066 |
| Mailing Address |
1015 State Route 121 Lincoln IL 62656-5355 |
| Practice Telephone | 2177322161 |
| Practice Fax Number | 2177353526 |
| Mailing Telephone | 2177923864 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2011-03-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 209-001819 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RECERTIFICATION OF CRNA | 37699 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346597622 | Gregory Tone Willis | Social Worker | 3000 Cherry Ln, Austin, TX 78703-2824 | 2012-08-06 |
| 1184605677 | Gregory S Willis | Obstetrics & Gynecology | 2035 Technology Pkwy Ste 201, Mechanicsburg, PA 17050-9497 | 2005-11-10 |
| 1417941600 | Gregory S Willis | Radiology | 6489 Sw Borland Rd, Tualatin, OR 97062-9798 | 2005-09-02 |
| 1326552902 | Gregory Lee Willis | Acupuncturist | 325 N Wiget Ln Ste 130, Walnut Creek, CA 94598-2435 | 2017-11-19 |
| Street Address |
200 STAHLHUT DR |
| City | LINCOLN |
| State | IL |
| Zip Code | 62656-5066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154329753 | Abraham Lincoln Memorial Hospital | General Acute Care Hospital | 200 Stahlhut Dr, Lincoln, IL 62656-5066 | 2005-07-08 |
| 1437502390 | Anthonia Ngozi Ijeli | Internal Medicine | 200 Stahlhut Dr, Lincoln, IL 62656-5066 | 2016-07-15 |
| 1437506557 | Luis Alejandro Diaz Quintero | Internal Medicine | 200 Stahlhut Dr, Lincoln, IL 62656-5066 | 2016-05-18 |
| 1033458450 | Mhs Heart Failure Clinic At Almh | Clinic/Center | 200 Stahlhut Dr, Lincoln, IL 62656-5066 | 2013-02-05 |
| 1730441742 | Erica Beutel | Physical Therapy Assistant | 200 Stahlhut Dr, Lincoln, IL 62656-5066 | 2012-06-14 |
| 1316209562 | Rhonda Kay Myers | Physical Therapy Assistant | 200 Stahlhut Dr, Lincoln, IL 62656-5066 | 2012-06-13 |
| 1811259062 | Amy Christine Knox | Physical Therapist | 200 Stahlhut Dr, Lincoln, IL 62656-5066 | 2012-06-13 |
| 1942562251 | Jodee Kay Leonard | Physical Therapist | 200 Stahlhut Dr, Lincoln, IL 62656-5066 | 2012-06-12 |
| 1487916797 | Julie Cross | Physical Therapist | 200 Stahlhut Dr, Lincoln, IL 62656-5066 | 2012-06-12 |
| 1700109782 | Karla J Carr | Occupational Therapist | 200 Stahlhut Dr, Lincoln, IL 62656-5066 | 2010-03-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437678943 | Carissa Jo O'donoghue | Speech-Language Pathologist | 1000 Railer Way, Lincoln, IL 62656 | 2017-09-15 |
| 1083972012 | Cynthia Dorchinecz | Speech-Language Pathologist | 200 Fifth Street, Lincoln, IL 62656 | 2012-04-27 |
| 1104100114 | Jan E Fehrenbacher | Pharmacist | 603 Woodlawn, Lincoln, IL 62656 | 2011-10-10 |
| 1053633263 | Tazwood Mental Health Center, Inc. | Community/Behavioral Health | 124-126 S. Chicago Street, Lincoln, IL 62656 | 2010-02-16 |
| 1649428756 | Diane E Ulrich | Dentist | 400 N. Chicago St, Lincoln, IL 62656 | 2008-09-03 |
| 1922202944 | Robert C Miller | Dentist | 217 S Kickapoo St, Lincoln, IL 62656 | 2007-06-13 |
| 1720290638 | Lifetime Dental Care of Illinois, PC | Dentist | 411 Keokuk Street, Lincoln, IL 62656 | 2007-05-04 |
| 1982734539 | Wal-mart Stores, Inc. Dba Wal-mart | Technician/Technologist | 825 Malerich Dr., Lincoln, IL 62656 | 2007-03-06 |
| 1861571663 | David R Hepler II | Chiropractor | 2000 Pulaski Street, Lincoln, IL 62656 | 2006-11-03 |
| 1477561793 | Raymond Todd Nobbe | Optometrist | 1400 Woodlawn Road, Lincoln, IL 62656 | 2006-08-03 |
| Find all providers in zip 62656 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699123976 | Walross Jim Basit | Nurse Anesthetist, Certified Registered | 4544 Bancroft Ave Apt 4, Lincoln, NE 68506-4272 | 2016-05-27 |
| 1053768945 | Clark Jackson | Nurse Anesthetist, Certified Registered | 2500 S 60th St Apt 21, Lincoln, NE 68506-3579 | 2016-05-20 |
| 1922345636 | Lime Rock Medical Inc. | Nurse Anesthetist, Certified Registered | 25 Southwick Dr, Lincoln, RI 02865-4821 | 2013-01-15 |
| 1093051989 | Carl C Blackwood | Nurse Anesthetist, Certified Registered | 5701 Lillibridge St Apt 10, Lincoln, NE 68506-3543 | 2012-12-20 |
| 1003973918 | Matthew C. Oliver | Nurse Anesthetist, Certified Registered | 6911 Van Dorn St Ste 2, Lincoln, NE 68506-6801 | 2007-01-02 |
| 1487745840 | Michael Paul Audette | Nurse Anesthetist, Certified Registered | 17 E Butterfly Way, Lincoln, RI 02865-3935 | 2006-09-28 |
| 1992751838 | Caroline E Breznyak | Nurse Anesthetist, Certified Registered | Transalpine Dr, Lincoln, ME 04457 | 2006-05-25 |
| 1992772453 | Michael D. Lawler | Nurse Anesthetist, Certified Registered | 2531 Marilynn Ave, Lincoln, NE 68502 | 2006-03-03 |
| 1396712154 | Cammi L Fitch | Nurse Anesthetist, Certified Registered | 575 S 70th St Ste 305, Lincoln, NE 68510 | 2006-03-01 |
| 1659346740 | Keith E Macksoud | Nurse Anesthetist, Certified Registered | 1817 Old Louisquisset Pike, Lincoln, RI 02865-4516 | 2006-02-22 |
| Find all providers in LINCOLN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.