BRADLEY REATHERFORD (NPI# 1326288812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326288812 |
Entity Type | Individual |
Full Name | BRADLEY REATHERFORD |
Practice Address |
221 Northeast Ave Peoria IL 61636-0001 |
Mailing Address |
1652 Belclare Rd Normal IL 61761-4925 |
Practice Telephone | 3096725654 |
Mailing Telephone | 2174540780 |
Enumeration Date | 2009-02-24 |
Last Update Date | 2009-07-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163W00000X | Registered Nurse | 041334740 | IL | Nursing Service Providers |
Y | 367500000X | Nurse Anesthetist, Certified Registered | 209007657 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
221 NORTHEAST AVE |
City | PEORIA |
State | IL |
Zip Code | 61636-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083857486 | Gretchen Joy Hackett | Registered Nurse | 221 Northeast Ave, Peoria, IL 61636-0001 | 2009-04-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962767376 | Aman Deep Singh | Psychiatry & Neurology | 221 Ne Glen Oak Ave. 7 West, Dept. of Psych. and Behavior Health., Peoria, IL 61636 | 2012-07-11 |
1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
1154856607 | Shubhada Reddy | Psychiatry & Neurology | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2017-04-21 |
1649657685 | Nicholas Grieco | Internal Medicine | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2015-04-29 |
1659703759 | Dhaval Save | Internal Medicine | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2013-07-31 |
1164474755 | Methodist Medical Center of Illinois | General Acute Care Hospital | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2006-05-16 |
1871560623 | Minna Jinn O'leary | Psychiatry & Neurology | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2006-03-01 |
1568901544 | Stephanie Ann Sullivan | Nurse Anesthetist, Certified Registered | Unity Point Health Methodist, 221 Ne Glen Oak Avenue, Peoria, IL 61636-0001 | 2017-02-23 |
1073066155 | Caroline Vanaman | Counselor | 221 Ne Glen Oak Ave # 7w, Peoria, IL 61636-0001 | 2016-07-26 |
1497141758 | Amber Hemminger | Registered Nurse | 200 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2015-04-13 |
Find all providers in zip 61636 |
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 |
---|---|---|---|---|
1013474071 | Vitalz Anesthesia Unlimited LLC | Nurse Anesthetist, Certified Registered | 6708 N Knoxville Ave Ste 1, Peoria, IL 61614-2863 | 2019-02-26 |
1568901544 | Stephanie Ann Sullivan | Nurse Anesthetist, Certified Registered | Unity Point Health Methodist, 221 Ne Glen Oak Avenue, Peoria, IL 61636-0001 | 2017-02-23 |
1033365291 | Mathew J Maupin | Nurse Anesthetist, Certified Registered | 5401 N. Knoxville Suite 416, Peoria, IL 61528 | 2008-08-07 |
1285802678 | Jenny Kunvarji Shah | Nurse Anesthetist, Certified Registered | 802 W Trailcreek Dr, Cosmetic Surgery Care, Peoria, IL 61614-1862 | 2008-02-19 |
1003919382 | Melissa Terhark | Nurse Anesthetist, Certified Registered | 8600 North State Route 91, Suite #250, Peoria, IL 61615 | 2006-09-05 |
1760419600 | Kristen L Manning | Nurse Anesthetist, Certified Registered | 8600 N State Route 91 Suite 250, Peoria, IL 61615-9506 | 2006-06-27 |
1518903798 | Marcus D Weeks | Nurse Anesthetist, Certified Registered | 8600 N State Route 91 Ste 250, Peoria, IL 61615-9506 | 2006-06-22 |
1942278130 | Larry J Kotewa | Nurse Anesthetist, Certified Registered | 124 W Whitehall Ct, Peoria, IL 61614-3032 | 2006-03-14 |
1588651566 | Timothy James Samolitis | Nurse Anesthetist, Certified Registered | 8600 N. State Route 91, Suite 250, Peoria, IL 61615 | 2005-10-04 |
1699761726 | Ann M Willemsen-dunlap | Nurse Anesthetist, Certified Registered | 8600 State Route 91 Ste 250, Peoria, IL 61615-7831 | 2005-09-23 |
Find all providers in PEORIA |
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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.