Active NPI
Matthew Shayne Miller, CRNA
- Certified Registered Nurse Anesthetist
- Columbus, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- APRNCRNA13371
- Practice address
- 410 W 10TH Ave
Columbus, OH 43210-1240 - Phone
- (614) 293-8487
- NPI assigned
- May 17, 2006
- Last updated
- Apr 2, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1268 | SC | |
| Certified Registered Nurse Anesthetist | 367500000X | APRNCRNA13371 | OH | Primary |
Addresses
Primary practice location
410 W 10TH Ave
Columbus, OH 43210-1240
Mailing address
700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-8487
Other practice location 1
1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4217
Other practice location 2
1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4217
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0067440 | Medicaid | OH | |
| AN0895 | Medicaid | SC |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mmiller14474@lickingmemorial.medicity.net | Other | LICKING MEMORIAL PROFESSIONAL CORPORATION |
| Direct Messaging Address | mmiller14474@lickingmemorial.medicity.net | Other | LICKING MEMORIAL PROFESSIONAL CORPORATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- University of South Carolina School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8487
75 Sylvania Dr
Beavercreek, OH 45440-3237
Phone (937) 320-5050
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1268 | SC | MD | Clinical Psychologist |
| APRNCRNA13371 | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Dynamics LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| New Albany Orthopedic Anesthesia LLC | Current | Accepting new patients | |
| Osu Observation Medicine, LLC | Current | Accepting new patients | |
| Radius Anesthesia of Ohio, LLC | Current | Accepting new patients | |
| Western Ohio Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Coshocton Anesthesia Professionals LTD | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Columbus Anesthesia Services LLC | Current | Accepting new patients | |
| Licking Memorial Professional Corporation | Past | Accepting new patients | |
| Anesthesiology Consultants of Columbia, PA | Past | Accepting new patients | |
| Orange ASC, LTD | Past | Accepting new patients | |
| Hendrick Anesthesia Network | Past | Accepting new patients |
Locations
111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700
100 E Campus View Blvd
Ste 250
Columbus, OH 43235
Phone (267) 817-8902
175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902
3600 Stelzer Rd
Ste 100
Columbus, OH 43219
Phone (614) 255-2900
410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905
410 W 10th Ave
#N429
Columbus, OH 43210
Phone (614) 293-4705
700 Ackerman Rd
Ste 2120
Columbus, OH 43202
700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046
1460 Orange St
Coshocton, OH 43812
Phone (740) 545-7919
4200 Indian Ripple Rd
Dayton, OH 45440
Phone (937) 320-5050
75 Sylvania Dr
Dayton, OH 45440
Phone (937) 320-5050
425 W 5th St
East Liverpool, OH 43920
Phone (330) 385-7200
9000 N Main St
Ste 405
Englewood, OH 45415
Phone (937) 320-5050
Organizations & group practices 11
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.
-
- Anesthesiology Physician
- Columbus, OH
- NPI 1407095052
-
- Certified Registered Nurse Anesthetist
- Beavercreek, OH
- NPI 1649777699
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Columbus, OH
- NPI 1801461025
-
- Anesthesiology Physician
- Coshocton, OH
- NPI 1770128795
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Columbus, OH
- NPI 1093762635
-
- Anesthesiology Physician
- Columbus, OH
- NPI 1427416585
-
- Anesthesiology Physician
- Bradenton, FL
- NPI 1073001012
Nurse Anesthetist, Certified Registered, OH
-
dba Licking Memorial Anesthesiology
- Anesthesiology Physician
- Newark, OH
- NPI 1376585430
-
dba Orthopedic ONE Surgery Center at Easton
- Ambulatory Surgical Clinic/Center
- Columbus, OH
- NPI 1619333010
-
- Anesthesiology Physician
- Columbia, SC
- NPI 1508846197
-
- Specialist
- Abilene, TX
- NPI 1851394993
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Special Hospital
- Columbus, OH
- NPI 1124127683
-
dba Ohio State University Dodd Rehabilitation Hospital
- Rehabilitation Hospital Unit
- Columbus, OH
- NPI 1184723637
-
- General Acute Care Hospital
- Columbus, OH
- NPI 1447359997
-
dba Ohio State University Harding Hospital
- Psychiatric Hospital Unit
- Columbus, OH
- NPI 1790876183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1063465706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 ACKERMAN RD STE 2120",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432021559",
"telephone_number": "614-293-8487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 W 10TH AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432101240",
"telephone_number": "614-293-8487"
}
],
"practiceLocations": [
{
"address_1": "1320 W Main St",
"address_purpose": "LOCATION",
"city": "Newark",
"state": "OH",
"postal_code": "430551822",
"country_code": "US",
"telephone_number": "220-564-4217",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1320 W Main St",
"address_purpose": "LOCATION",
"city": "Newark",
"state": "OH",
"postal_code": "430551822",
"country_code": "US",
"telephone_number": "220-564-4217",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "MATTHEW",
"middle_name": "SHAYNE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "SC",
"license": "1268",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "APRNCRNA13371",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0067440",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "AN0895",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mmiller14474@lickingmemorial.medicity.net",
"affiliation": "Y",
"endpointDescription": "DIRECT EMAIL ADDRESS",
"affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "OTHER",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "1320 W Main St",
"city": "Newark",
"state": "OH",
"country_code": "US",
"postal_code": "430551822",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mmiller14474@lickingmemorial.medicity.net",
"affiliation": "Y",
"endpointDescription": "DIRECT EMAIL ADDRESS",
"affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "OTHER",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "1320 W Main St",
"city": "Newark",
"state": "OH",
"country_code": "US",
"postal_code": "430551822",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.