Granite City Clinic Corp
NPI 1003892464 · Certified Registered Nurse Anesthetist · Granite City, IL
Granite City Clinic Corp is a Certified Registered Nurse Anesthetist organization in Granite City, IL (NPI 1003892464).
Provider details
- NPI number
- 1003892464
- Entity type
- Organization
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Gary Newsome, Vp(615) 465-7000
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Anesthesiology Physician207L00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Granite City Anesthesia
Registry dates
- Enumerated
- 2005-12-19
- Last updated
- 2007-07-30
Frequently asked questions
- What is Granite City Clinic Corp's NPI number?
- Granite City Clinic Corp's National Provider Identifier (NPI) is 1003892464, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Granite City Clinic Corp?
- Granite City Clinic Corp is classified in the NPPES registry as Certified Registered Nurse Anesthetist (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Granite City Clinic Corp located?
- Granite City Clinic Corp's practice location on file with NPPES is 2100 Madison Ave, Granite City, IL 62040-4701.
- What is Granite City Clinic Corp's phone number?
- The practice phone number listed in the NPPES registry for Granite City Clinic Corp is (618) 798-3000.
- Who is the authorized official for Granite City Clinic Corp?
- The authorized official listed on Granite City Clinic Corp's NPPES record is Gary Newsome, Vp. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Granite City Clinic Corp's NPI active?
- Yes — Granite City Clinic Corp's NPI (1003892464) is active in the NPPES registry as of the last update on 2007-07-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.