KRISTOPHER D DETERS (NPI# 1417583501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417583501 |
| Entity Type | Individual |
| Full Name | KRISTOPHER D DETERS |
| Credential | APRN, CRNA |
| Practice Address |
611 W Park St Urbana IL 61801-2529 |
| Mailing Address |
611 W Park St Fapc Urbana IL 61801 |
| Practice Telephone | 2173833303 |
| Practice Fax Number | 2173833265 |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 209021043 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
611 W PARK ST |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831193416 | Mark L Saxton | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2005-06-10 |
| 1083214514 | Karissa Nelson | Physical Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-10-26 |
| 1720698756 | Justin Matthew Felix | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-08-04 |
| 1033729306 | Patricia Fairchild | Occupational Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-08-03 |
| 1851909782 | Shruti Agarwal | Internal Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-16 |
| 1396363321 | Muhammad Umair Rana | Internal Medicine | 611 W Park St, Urbana, IL 61801 | 2020-07-07 |
| 1740807817 | Salma Malik | Internal Medicine | 611 W Park St, Urbana, IL 61801 | 2020-07-06 |
| 1477171536 | Audrey T Lam | Internal Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-06 |
| 1255959318 | Corbin Reid Mah | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-06 |
| 1093332652 | Knika Sethi | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| 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 |
|---|---|---|---|---|
| 1700831740 | Kimberly A Crosland | Nurse Anesthetist, Certified Registered | 3823 Kendall Dr, Urbana, MD 21704-7884 | 2006-05-24 |
| 1790318707 | Brandi Dawson | Nurse Anesthetist, Certified Registered | 611 W Park St, Urbana, IL 61801-2529 | 2020-02-18 |
| 1003478942 | Minwoo Kim | Nurse Anesthetist, Certified Registered | 611 W Park St, Urbana, IL 61801-2529 | 2019-07-01 |
| 1942764501 | Devon N Little | Nurse Anesthetist, Certified Registered | 611 W Park St, Urbana, IL 61801-2529 | 2019-01-29 |
| 1841795374 | Carolyn Rigsby | Nurse Anesthetist, Certified Registered | 611 W Park St, Urbana, IL 61801-2529 | 2018-03-27 |
| 1467960104 | David M Frazier | Nurse Anesthetist, Certified Registered | 611 W Park St, Urbana, IL 61801-2529 | 2018-01-16 |
| 1639686835 | Sarah L Reising | Nurse Anesthetist, Certified Registered | 611 W Park St, Urbana, IL 61801-2529 | 2018-01-09 |
| 1760993729 | Maureen E Mcilhany | Nurse Anesthetist, Certified Registered | 611 W Park St, Urbana, IL 61801-2529 | 2017-10-18 |
| 1912430703 | Rahul Sinha | Nurse Anesthetist, Certified Registered | 611 W Park St, Anesthesiology, Urbana, IL 61801-2529 | 2017-04-07 |
| 1053851626 | Yana V. Reynolds | Nurse Anesthetist, Certified Registered | 611 W Park St, Anesthesiology, Urbana, IL 61801-2529 | 2017-03-02 |
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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.