Individual provider Active NPI

Trey Overla

  • Certified Registered Nurse Anesthetist
  • Dayton, OH
National Provider Identifier
1073264602
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.0020416 Issued in OH
Practice address
405 W Grand Ave
Dayton, OH 45405-7538
Phone
(937) 723-3200
NPI assigned
Jan 14, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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 APRN.CRNA.0020416 OH Primary

Addresses

Primary practice location

405 W Grand Ave
Dayton, OH 45405-7538

Mailing address

216 Hamilton St
West Milton, OH 45383-1627
Phone (937) 477-2018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220222001925 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042604712 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lima Memorial Professional CorporationGroup PAC ID 1254232184, 167 clinicians
Peak Anesthesia Management LLCGroup PAC ID 3476079591, 9 clinicians
Dayton Anesthesia and Pain Services LLCGroup PAC ID 8022245372, 217 clinicians

Practice addresses (Care Compare)

1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone (419) 998-4575

1118 Fairington Dr
Sidney, OH 45365-8913
Phone (937) 492-3755

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4000

Hospital & facility affiliations

  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Lima Memorial Health System Hospital, Lima, OH, CCN 360009
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Professional Corporation CurrentSince Nov 8, 2024 Accepting new patients
Dayton Anesthesia & Pain Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2022 Accepting new patients
Lima Memorial Professional Corporation CurrentSince Nov 8, 2024 Accepting new patients
Peak Anesthesia Management LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

L3982
Columbus, OH 43260

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

1118 Fairington Dr
Sidney, OH 45365
Phone (937) 492-3755

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1073264602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 HAMILTON ST",
            "city": "WEST MILTON",
            "state": "OH",
            "postal_code": "453831627",
            "telephone_number": "937-477-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GRAND AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454057538",
            "telephone_number": "937-723-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERLA",
        "first_name": "TREY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.0020416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.

Verify at the official NPI Registry.