CARL ROBERT DAVIS (NPI# 1992188338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992188338 |
| Entity Type | Individual |
| Full Name | CARL ROBERT DAVIS |
| Credential | CRNA |
| Practice Address |
2 Good Samaritan Way Suite 205 Mount Vernon IL 62864-2408 |
| Mailing Address |
4227 Lincolnshire Dr Mount Vernon IL 62864-2157 |
| Practice Telephone | 6182411108 |
| Practice Fax Number | 6182413805 |
| Mailing Telephone | 6182411108 |
| Mailing Fax Number | 6182413805 |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 209012907 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467583393 | Carl Spencer Davis | Family Medicine | 801 Ne Anderson Ln, Lees Summit, MO 64064-1244 | 2007-03-09 |
| 1629186770 | Carl Richard Davis | Emergency Medicine | 1102 Ne Parvin Road, #302, Kansas City, MO 64116 | 2006-08-28 |
| 1114951407 | Carl C Davis Jr. | Emergency Medicine | 4009 Tennyson St, Houston, TX 77005-2747 | 2006-07-10 |
| 1376594044 | Carl Alexander Davis | Family Medicine | 212 Russell Blvd, Nacogdoches, TX 75965-1237 | 2006-05-15 |
| 1477019602 | Carl Nathaniel Davis | Marriage & Family Therapist | 2640 Industry Way, Lynwood, CA 90262-4284 | 2019-02-12 |
| 1760853527 | Carl Davis | Counselor | 4480 Gen Degaulle Dr, Suite 117, New Orleans, LA 70131-6941 | 2015-10-19 |
| 1134476765 | Carl Davis | Counselor | 324 E Chestnut St, Coweta, OK 74429-2532 | 2012-08-14 |
| 1427385079 | Carl Gene Davis | Licensed Practical Nurse | 1215 Nw 25th St, Oklahoma City, OK 73106-5629 | 2009-11-03 |
| 1154522993 | Carl Webster Davis Jr. | Pharmacist | 209 4th Ave Ne, Cullman, AL 35055-1904 | 2007-05-30 |
| 1881764009 | Carl Derrick Davis | Counselor | 1605 Eastlake Ave, Los Angeles, CA 90033-1009 | 2006-11-08 |
| Street Address |
2 GOOD SAMARITAN WAY SUITE 205 |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718900 | Ssm Health Businesses | Hospice Care, Community Based | 2 Good Samaritan Way, Suite 325, Mount Vernon, IL 62864-2408 | 2005-05-24 |
| 1417573734 | Scherrie Lynn Medina | Registered Nurse | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2020-06-23 |
| 1245711779 | Mary K Mcgarvey | Occupational Therapy Assistant | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2018-08-23 |
| 1831611334 | Patricia Isabel Calcetto | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2017-07-17 |
| 1821548207 | Nicole Vetter | Nurse Practitioner | 2 Good Samaritan Way, Medical Plaza Suite 420, Mount Vernon, IL 62864-2408 | 2016-10-10 |
| 1740654821 | Kathryn Flanigan | Speech-Language Pathologist | 2 Good Samaritan Way, 3rd Floor, Mount Vernon, IL 62864-2408 | 2015-11-30 |
| 1275900656 | Christopher Bourget | Registered Nurse | 2 Good Samaritan Way, Medical Plaza Suite 205, Mount Vernon, IL 62864-2408 | 2015-09-01 |
| 1871919845 | Michell R Ellis | Pharmacist | 2 Good Samaritan Way, Suite 120, Mount Vernon, IL 62864-2408 | 2014-03-13 |
| 1548685647 | Rebecca Breanne Ritchey | Speech-Language Pathologist | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2014-02-26 |
| 1275954778 | Karla Webb | Nurse Practitioner | 2 Good Samaritan Way, Suite 220, Mount Vernon, IL 62864-2408 | 2013-12-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| 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 |
|---|---|---|---|---|
| 1043757487 | Anesthesia Associates of Southern Illinois Surgery Center LLC | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way Ste 200, Mount Vernon, IL 62864-2476 | 2017-01-24 |
| 1952321879 | Kent Alan Fair | Nurse Anesthetist, Certified Registered | 1011 Wilshire Dr, Mount Vernon, IL 62864-2743 | 2006-07-21 |
| 1417984105 | Julie A Aulds | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way Ste 205, Mount Vernon, IL 62864-2476 | 2006-06-27 |
| 1689636540 | David L Stittsworth | Nurse Anesthetist, Certified Registered | 17713 E Shadow Lake Rd, Mount Vernon, IL 62864-8136 | 2006-04-05 |
| 1386623494 | Alison E Sanker | Nurse Anesthetist, Certified Registered | 2900 Broadway St, Suite B, Mount Vernon, IL 62864-2341 | 2006-01-17 |
| 1326037052 | Daniel Mark Greenwald | Nurse Anesthetist, Certified Registered | 111 S 13th St, Mount Vernon, WA 98274-4105 | 2005-10-15 |
| 1437719093 | Vincent Coty Compton | Nurse Anesthetist, Certified Registered | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2019-06-17 |
| 1598320558 | Joshua David Delozier | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way Ste 205, Mount Vernon, IL 62864-2476 | 2019-05-06 |
| 1184191363 | Jeanette Ilene Ellis | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way Ste 205, Mount Vernon, IL 62864-2476 | 2018-10-25 |
| 1831611334 | Patricia Isabel Calcetto | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2017-07-17 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.