Granite City Clinic Corp
NPI 1003892464ActiveOrganization· Nurse Anesthetist, Certified Registered· Granite City, IL
Nurse Anesthetist, Certified Registered in Granite City, Illinois, registered in NPPES in December 2005. The authorized official on file is Gary Newsome, Vp.
Overview
| NPI | 1003892464 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 19, 2005 |
| Last updated in NPPES | Jul 30, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | — | — |
| Anesthesiology | 207L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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