SHAWN MICHAEL WYNN (NPI# 1750749826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750749826 |
| Entity Type | Individual |
| Full Name | SHAWN MICHAEL WYNN |
| Practice Address |
210 W Walnut St Canton IL 61520 |
| Mailing Address |
210 W Walnut St Canton IL 61520-2444 |
| Practice Telephone | 3096475240 |
| Mailing Telephone | 3096475240 |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2018-08-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 209.013769 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205990843 | Shawn W Wynn | Orthopaedic Surgery | 520 Valley View Dr, Moline, IL 61265-6194 | 2006-12-20 |
| Street Address |
210 W WALNUT ST |
| City | CANTON |
| State | IL |
| Zip Code | 61520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376540559 | Andrew Roudebush | Family Medicine | 210 W Walnut St, Canton, IL 61520-2444 | 2005-07-04 |
| 1063046464 | Dara Marie Wagner | Nurse Practitioner | 210 W Walnut St, Canton, IL 61520-2444 | 2020-02-25 |
| 1235699893 | Christina Willey | Occupational Therapist | 210 W Walnut St, Canton, IL 61520-2444 | 2019-03-20 |
| 1487174744 | Joshua J Wilkinson | Nurse Practitioner | 210 W Walnut St, Canton, IL 61520-2444 | 2017-06-27 |
| 1124482252 | Ryan Deushane | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-04-05 |
| 1790143683 | Midwest Mobile Anesthesia Consultants, Sc | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520-2444 | 2016-02-05 |
| 1417312232 | Danielle Marianna Sausaman | Dietitian, Registered | 210 W Walnut St, Graham Hospital Food and Nutrition Services, Canton, IL 61520 | 2015-12-21 |
| 1932530938 | Amy Sammis | Dietitian, Registered | 210 W Walnut St, Canton, IL 61520-2444 | 2013-12-02 |
| 1609111988 | William Severt | Physical Therapist | 210 W Walnut St, Canton, IL 61520-2444 | 2012-11-28 |
| 1437448578 | Sandra Anne Haws | Dietitian, Registered | 210 W Walnut St, Canton, IL 61520-2444 | 2011-03-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497978480 | Walton Cs-xi P.C. | Chiropractor | 410 E. Elm Street, Canton, IL 61520 | 2007-04-10 |
| 1811912918 | Jennifer Christine Daniel-price | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2006-07-12 |
| 1245216241 | Fulton County Health Department | Clinic/Center | 700 East Oak Street, Canton, IL 61520 | 2005-12-21 |
| 1740533835 | Abby L. Sherwood | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2012-10-26 |
| 1417261041 | Erin Kathleen Buckley | Obstetrics & Gynecology | 180 S Main St, Canton, IL 61520 | 2010-08-06 |
| 1619375532 | Brittany Nicole Miller | Nurse Practitioner | 1300 E Locust St, Canton, IL 61520-0008 | 2014-12-09 |
| 1437197845 | Heartland of Canton Il LLC | Clinic/Center | 2081 N Main St, Canton, IL 61520-1032 | 2006-06-04 |
| 1568063428 | Mary J Eberle | Pharmacist | 2071 N Main St, Canton, IL 61520-1032 | 2020-11-05 |
| 1659970267 | Amanda Sue Kinne | Pharmacist | 2071 N Main St, Canton, IL 61520-1032 | 2020-10-23 |
| 1952879132 | Loft Rehabilitation and Nursing of Canton LLC | Skilled Nursing Facility | 2081 N Main St, Canton, IL 61520-1032 | 2018-11-06 |
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| 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 |
|---|---|---|---|---|
| 1396264040 | Brandi Hanchosky | Nurse Anesthetist, Certified Registered | 4665 Douglas Cir Nw # 100, Canton, OH 44718-3673 | 2017-09-13 |
| 1952841637 | Andrew Joseph Proctor | Nurse Anesthetist, Certified Registered | 800 Pheasant Woods Drive, Canton, MI 48188-5224 | 2017-03-01 |
| 1083166383 | Khushbu Modi | Nurse Anesthetist, Certified Registered | 276 Harmony Lake Dr, Canton, GA 30115-4781 | 2016-11-03 |
| 1760930572 | Branden Joaquin Sibley | Nurse Anesthetist, Certified Registered | 6889 Wales Crossing St Nw Apt D, Canton, OH 44720-5383 | 2016-09-21 |
| 1366845554 | Mississippi Anesthesia Group, LLC | Nurse Anesthetist, Certified Registered | 145 Sanctuary Ln, Canton, MS 39046-6601 | 2014-10-01 |
| 1104236884 | Anne Elizabeth Murray | Nurse Anesthetist, Certified Registered | 173 Dedham St, Canton, MA 02021-1560 | 2014-05-02 |
| 1952593865 | Brett T King | Nurse Anesthetist, Certified Registered | 208 Towne Overlook Dr, Canton, GA 30114-7239 | 2007-08-14 |
| 1184767436 | Sed 8 Inc. | Nurse Anesthetist, Certified Registered | 1017 Field St Nw, Canton, OH 44709-1635 | 2007-02-15 |
| 1144246190 | Elfrieda Marie Londeree | Nurse Anesthetist, Certified Registered | Ohio Hospital Based Physician Corp, 2600 Sixth Street Sw, Canton, OH 44710 | 2006-07-14 |
| 1528010675 | Brian K Norcia | Nurse Anesthetist, Certified Registered | 4665 Douglas Cir Nw Ste 100, Canton, OH 44718-3673 | 2006-05-17 |
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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.