Individual provider Active NPI

Charles N Smith, CRNA

  • Certified Registered Nurse Anesthetist
  • Troy, OH
National Provider Identifier
1053345561
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN-123875 Issued in OH
Practice address
3130 N County Road 25a
Troy, OH 45373-1337
Phone
(614) 459-7830
Fax
(614) 459-7824
NPI assigned
Jul 10, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN-123875 OH Primary

Addresses

Primary practice location

3130 N County Road 25a
Troy, OH 45373-1337

Mailing address

3366 Riverside Drive
Suite 200
Columbus, OH 43221
Phone (614) 459-7830

Other identifiers 1

IdentifierTypeStateIssuer
0756383MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN-123875OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Anesthesiology, Inc Past Accepting new patients
Anesthesiology Consultants of Toledo, Inc Past Accepting new patients
Miami Valley Anesthesia Past Accepting new patients
Medical Center at Elizabeth Place LLC Past Accepting new patients
Kettering Anesthesia Associates, Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053345561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 RIVERSIDE DRIVE",
            "address_2": "SUITE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43221",
            "telephone_number": "614-459-7830",
            "fax_number": "614-459-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 N COUNTY ROAD 25A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731337",
            "telephone_number": "614-459-7830",
            "fax_number": "614-459-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "N",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN-123875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0756383",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.