GRANITE CITY ANESTHESIA
NPI 1003892464
Nurse Anesthetist, Certified Registered in Granite City, IL

Active since December 19, 2005
2100 MADISON AVE, GRANITE CITY, IL 62040(618) 798-3000 Get Directions Write a Review

NPPES record last updated: July 30, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Nurse Anesthetist, Certified Registered

About GRANITE CITY ANESTHESIA

This page provides the complete NPI Profile along with additional information for Granite City Anesthesia, a provider established in Granite City, Illinois operating as a Nurse Anesthetist, Certified Registered. The healthcare provider is registered in the NPI registry with number 1003892464 assigned on December 2005. The practitioner's primary taxonomy code is 367500000X. The provider is registered as an organization and their NPI record was last updated 19 years ago. Granite City Anesthesia operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Granite City Anesthesia. The authorized official of this NPI record is Gary Newsome (Vp)

NPI
1003892464 Verify this NPI
Provider Legal Name
GRANITE CITY CLINIC CORP
Other Organization Name
GRANITE CITY ANESTHESIA
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2100 MADISON AVE GRANITE CITY, IL 62040
Location Phone
(618) 798-3000
Mailing Address
P O BOX 503734 SAINT LOUIS, MO 63150
Mailing Phone
(660) 826-5960
Mailing Fax
(660) 826-4852
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-19-2005
Last Update Date
07-30-2007
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Anesthetist, Certified Registered

Taxonomy Code
367500000X
Type
Physician Assistants & Advanced Practice Nursing Providers
Taxonomy Description
(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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207L00000XAllopathic & Osteopathic Physicians

Anesthesiology

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

GARY NEWSOME

Authorized Official Title
VP
Authorized Official Phone
(615) 465-7000

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
208168MEDICARE PIN (08)TN 

Reviews for GRANITE CITY ANESTHESIA

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Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine
2100 MADISON AVE
GRANITE CITY, IL 62040
Nurse Anesthetist, Certified Registered
2100 MADISON AVE
GRANITE CITY, IL 62040
Nurse Anesthetist, Certified Registered
2100 MADISON AVE
GRANITE CITY, IL 62040
Hospice Care, Community Based
2100 MADISON AVE
GRANITE CITY, IL 62040
Pediatrics
2100 MADISON AVE
GRANITE CITY, IL 62040
Nurse Anesthetist, Certified Registered
2100 MADISON AVE
GRANITE CITY, IL 62040
Emergency Medicine
2100 MADISON AVE
GRANITE CITY, IL 62040
Emergency Medicine
2100 MADISON AVE
GRANITE CITY, IL 62040
Clinic/Center (Federally Qualified Health Center (FQHC))
2100 MADISON AVE
GRANITE CITY, IL 62040
Emergency Medicine
2100 MADISON AVE
GRANITE CITY, IL 62040
Emergency Medicine
2100 MADISON AVE
GRANITE CITY, IL 62040
Social Worker (Clinical)
2100 MADISON AVE, STE. 303
GRANITE CITY, IL 62040
Clinical Medical Laboratory
2100 MADISON AVE
GRANITE CITY, IL 62040
Pharmacist
2100 MADISON AVE
GRANITE CITY, IL 62040
Family Medicine
2100 MADISON AVE
GRANITE CITY, IL 62040
Dietitian, Registered
2100 MADISON AVE
GRANITE CITY, IL 62040
Dietitian, Registered
2100 MADISON AVE
GRANITE CITY, IL 62040
Dietitian, Registered (Nutrition, Metabolic)
2100 MADISON AVE
GRANITE CITY, IL 62040
Anesthesiology
2100 MADISON AVE
GRANITE CITY, IL 62040
Nurse Anesthetist, Certified Registered
2100 MADISON AVE
GRANITE CITY, IL 62040

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003892464, enumerated as an "organization" on December 19, 2005.

The provider is located at 2100 MADISON AVE GRANITE CITY, IL 62040 and the phone number is (618) 798-3000.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.