KENNETH UNZICKER (NPI# 1194767202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194767202 |
| Entity Type | Individual |
| Full Name | KENNETH UNZICKER |
| Credential | CRNA |
| Practice Address |
1015 S Mercer Ave Bloomington IL 61701 |
| Mailing Address |
Po Box 795142 St Louis MO 63179 |
| Practice Telephone | 3096624321 |
| Practice Fax Number | 3096614532 |
| Mailing Telephone | 3096624321 |
| Mailing Fax Number | 3096614532 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 05732031 | 01 |
| Street Address |
1015 S MERCER AVE |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215924410 | Ramsin Benyamin | Anesthesiology | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2005-10-03 |
| 1487164869 | Vitalrehab Physical Therapy, LLC | Clinic/Center | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2017-10-11 |
| 1639565971 | Champion Fitness, Inc | Clinic/Center | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2015-04-14 |
| 1659650455 | Stephanie Anne Butler | Nurse Practitioner | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2011-08-10 |
| 1043504764 | Donny Bounds | Registered Nurse | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2011-05-31 |
| 1528233111 | Applied Pain Institute, LLC | Pain Medicine | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2008-04-24 |
| 1831360239 | Midwest Neuromonitoring, Inc. | Physiological Laboratory | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2008-03-13 |
| 1336319094 | Amaresh Vydyanathan | Anesthesiology | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2008-03-08 |
| 1972789238 | Jason Michael Seibly | Neurological Surgery | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2008-01-17 |
| 1275729659 | Neurology Solutions | Clinic/Center | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2007-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| 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 |
|---|---|---|---|---|
| 1376105684 | Tel Anesthesia, Ltd | Nurse Anesthetist, Certified Registered | 7 Flint Ct, Bloomington, IL 61705-8830 | 2019-07-08 |
| 1124205034 | Thomas Eric Laver | Nurse Anesthetist, Certified Registered | 11 Ann Arbor Ct, Bloomington, IL 61705-8807 | 2008-01-23 |
| 1497792659 | Charles Vincent Woodson | Nurse Anesthetist, Certified Registered | 2920 Mcintire Drive, Suite 150, Attn: Maria Mitchell, Bloomington, IN 47403 | 2006-05-31 |
| 1295701613 | Jason Richard Huber | Nurse Anesthetist, Certified Registered | 2022 E Taylor St, Bloomington, IL 61701-5716 | 2006-02-25 |
| 1144712563 | Tcom Specialty Physicians, LLC | Nurse Anesthetist, Certified Registered | 2502 E Empire St Ste B, Bloomington, IL 61704 | 2018-06-01 |
| 1952703548 | Amanda Hope Qunli Gu | Nurse Anesthetist, Certified Registered | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2014-09-25 |
| 1669805313 | Emily A Warner | Nurse Anesthetist, Certified Registered | 1505 Eastland Dr, Suite Ll1000, Bloomington, IL 61701-3534 | 2013-08-16 |
| 1629357348 | Carrie M Rodgers | Nurse Anesthetist, Certified Registered | 1505 Eastland Dr, Ll1400, Bloomington, IL 61701-3534 | 2011-08-11 |
| 1306143532 | Ronald E Richardson | Nurse Anesthetist, Certified Registered | 1505 Eastland Dr, Ll 1400, Bloomington, IL 61701-3534 | 2011-02-24 |
| 1225297484 | Julie R Heisel-wolter | Nurse Anesthetist, Certified Registered | 1505 Eastland Dr, Suite Ll 1400, Bloomington, IL 61701-3534 | 2008-06-03 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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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.